Provider Demographics
NPI:1386406940
Name:STEVENS, NATALIE (LPCA)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 AVINSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-5374
Mailing Address - Country:US
Mailing Address - Phone:919-270-4780
Mailing Address - Fax:
Practice Address - Street 1:2209 AVINSHIRE PL
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5374
Practice Address - Country:US
Practice Address - Phone:919-270-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health