Provider Demographics
NPI:1194580159
Name:DEVER-HARRIS, STEPHEN (LMFT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DEVER-HARRIS
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E CHURCH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-4309
Mailing Address - Country:US
Mailing Address - Phone:689-800-3572
Mailing Address - Fax:
Practice Address - Street 1:324 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-4309
Practice Address - Country:US
Practice Address - Phone:321-247-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3849106H00000X
FLMT5130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist