Stephenson, John D
Stephenson, John D is an sole proprietor health care provider with primary practice located at 1309 Camas St , Blackfoot ID 83221-3060. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Stephenson, John D can be contacted via phone (208) 782-0675.Contact Information
Primary practice address
1309 Camas St
Blackfoot ID 83221-3060
Phone: (208) 782-0675
Fax: (208) 782-0678
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LCSW-26187 | Idaho |
Profile Details
| NPI number | 1528126158 |
|---|---|
| LBN Legal business name | Stephenson, John D |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Aug 4th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528126158 | NPPES |
| Idaho | MEDICAID | 806939500 | |
| Idaho | MEDICAID | 807352800 |
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