Provider Demographics
NPI:1215175906
Name:DEQUEVEDO, STEVEN AUGUSTO (LPC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:AUGUSTO
Last Name:DEQUEVEDO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 CHERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8839
Mailing Address - Country:US
Mailing Address - Phone:405-751-2227
Mailing Address - Fax:
Practice Address - Street 1:4108 CHERRY HILL LN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8839
Practice Address - Country:US
Practice Address - Phone:405-751-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health