Provider Demographics
NPI:1427888536
Name:DEVON'S PLACE
Entity type:Organization
Organization Name:DEVON'S PLACE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEPANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, RPT
Authorized Official - Phone:678-561-5831
Mailing Address - Street 1:41 LENOX POINTE NE STE B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-7424
Mailing Address - Country:US
Mailing Address - Phone:678-597-8084
Mailing Address - Fax:
Practice Address - Street 1:41 LENOX POINTE NE STE B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-7424
Practice Address - Country:US
Practice Address - Phone:678-597-8084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1467807198OtherLCSW
GA1104296052OtherLCSW