Provider Demographics
NPI:1104493113
Name:STEPHENSON, STEVEN (LMHC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-2802
Mailing Address - Country:US
Mailing Address - Phone:575-461-8631
Mailing Address - Fax:
Practice Address - Street 1:220 S 3RD ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2802
Practice Address - Country:US
Practice Address - Phone:575-461-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health