John D Stephenson, LCSW
Counselor, Mental Health in Blackfoot, ID. Individual provider (NPI-1).
NPI number1528126158
StatusActive
Last updated in NPPESAug 4, 2014
Details
- NPI
- 1528126158
- Entity type
- Individual (NPI-1)
- Name
- Mr. John D Stephenson
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2006
- Last updated
- Aug 4, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | LCSW-26187 | ID | Yes |
Practice location
1309 Camas StBlackfoot, ID 83221-3060
Phone 208-782-0675 · Fax 208-782-0678
Mailing address
Po Box 903Blackfoot, ID 83221-0903
Phone 208-782-0675 · Fax 208-782-0678
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