Provider Demographics
NPI:1962576553
Name:LEHMAN, STEPHEN R (LLP, CAC-II, CAAC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:LLP, CAC-II, CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51007 SADDLEBAG RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:MI
Mailing Address - Zip Code:49045-9420
Mailing Address - Country:US
Mailing Address - Phone:269-476-9781
Mailing Address - Fax:
Practice Address - Street 1:17321 M 60
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:MI
Practice Address - Zip Code:49095-9775
Practice Address - Country:US
Practice Address - Phone:269-476-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical