Provider Demographics
NPI:1699924738
Name:STEVENS, BARBARA ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 W STATE ST
Mailing Address - Street 2:STE B
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-5059
Mailing Address - Country:US
Mailing Address - Phone:208-853-5095
Mailing Address - Fax:
Practice Address - Street 1:5999 W STATE ST
Practice Address - Street 2:STE B
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-5059
Practice Address - Country:US
Practice Address - Phone:208-853-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID373101YP2500X
ID1934104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker