The Stevens Psychology Clinic

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

040248 Issued in GA

Legal business name

THE STEVENS PSYCHOLOGY CLINIC

Doing business as

The Stevens Clinic

Practice address

405 S Thornton Ave
Dalton, GA 30720-8285

Phone

(706) 226-1146

Fax

(706) 226-1483

NPI assigned

May 8, 2008

Last updated

May 8, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Stephanie Smith

Title

Office Manager

Phone

(706) 226-1146

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Stevens Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David T. Stevens, PH.D.

  • Clinical Psychologist
  • Dalton, GA
  • NPI 1831133438
  Medicare reassignment NPD
• Lisa H. Stevens, M.D.

  • Psychiatry Physician
  • Dalton, GA
  • NPI 1578590311

  Child & Adolescent Psychiatry

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1033385158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SOUTH THORNTON AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-226-1146",
            "fax_number": "706-226-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S THORNTON AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208285",
            "telephone_number": "706-226-1146",
            "fax_number": "706-226-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE STEVENS PSYCHOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-226-1146",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "001895",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "040248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00665871D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00675353D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Stevens Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Dalton, GA
• Providers in Dalton, GA by specialty
• Child & Adolescent Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.