Stevens, Mary
Stevens, Mary is an sole proprietor health care provider with primary practice located at 7101 York Ave S Suite 161, Edina MN 55435-4450. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Stevens, Mary can be contacted via phone (652) 921-9964.Contact Information
Primary practice address
7101 York Ave S Suite 161
Edina MN 55435-4450
Phone: (652) 921-9964
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP0970 | Minnesota |
Profile Details
| NPI number | 1104881051 |
|---|---|
| LBN Legal business name | Stevens, Mary |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Dec 3rd, 2010 - about 14 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 | 1104881051 | NPPES |
| Minnesota | Other | 16890ST | BLUE CROSS |
| Minnesota | MEDICAID | 476347500 | BLUE CROSS |
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