Provider Demographics
NPI:1952168163
Name:STEVENS, SAVANNA PATRICIA (PLPC)
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:PATRICIA
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 W 119TH CT APT 421
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4861
Mailing Address - Country:US
Mailing Address - Phone:618-443-7375
Mailing Address - Fax:
Practice Address - Street 1:6155 OAK ST STE C
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2266
Practice Address - Country:US
Practice Address - Phone:816-678-0144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023018414101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health