Provider Demographics
NPI:1386778173
Name:STEVENS, KAREN (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 PEARL ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4366
Mailing Address - Country:US
Mailing Address - Phone:303-725-8159
Mailing Address - Fax:303-280-0234
Practice Address - Street 1:9101 PEARL ST
Practice Address - Street 2:SUITE 218
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4366
Practice Address - Country:US
Practice Address - Phone:303-725-8159
Practice Address - Fax:303-280-0234
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9927831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC468658Medicare PIN