Provider Demographics
NPI:1316370083
Name:STEPHENSON, CHRISTINE (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 REDCLIFF CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81432-9239
Mailing Address - Country:US
Mailing Address - Phone:970-901-0394
Mailing Address - Fax:
Practice Address - Street 1:320 N 3RD ST.
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425
Practice Address - Country:US
Practice Address - Phone:970-252-4688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health