Provider Demographics
NPI:1851110415
Name:STEVENS, KAREN BROOK (BA, MLS, BHT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:BROOK
Last Name:STEVENS
Suffix:
Gender:F
Credentials:BA, MLS, BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 S DOBSON RD STE 200-267
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6488
Mailing Address - Country:US
Mailing Address - Phone:480-322-5619
Mailing Address - Fax:
Practice Address - Street 1:2266 S DOBSON RD STE 200-267
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6488
Practice Address - Country:US
Practice Address - Phone:480-322-5619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator