Active NPI
Mary S Stevens, LCSW
- Mental Health Counselor
- Suffolk, VA
National Provider Identifier
1063407906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0904002094
- Practice address
- 1000 Commercial LN
Wtcsb
Suffolk, VA 23434-8148 - Phone
- (757) 942-1069
- Fax
- (757) 925-2213
- NPI assigned
- Sep 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0904002094 | VA | Primary |
Addresses
Primary practice location
1000 Commercial LN
Wtcsb
Suffolk, VA 23434-8148
Mailing address
1000 Commercial LN
Wtcsb
Suffolk, VA 23434-8148
Phone (757) 942-1069
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8904766 | Medicaid | VA | |
| O83006 | Other | VA | OPITMA FAMILY CARE |
| 270371 | Other | VA | TRIGONBC/BS HEALTHKEEPERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Tidewater Community Mental | Past | Accepting new patients | |
| Comprehensive Psychological Services | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Chesapeake, VA
- NPI 1598861387
Mental Health
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Suffolk, VA
- NPI 1689615296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063407906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 COMMERCIAL LN",
"address_2": "WTCSB",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234348148",
"telephone_number": "757-942-1069",
"fax_number": "757-925-2213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 COMMERCIAL LN",
"address_2": "WTCSB",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234348148",
"telephone_number": "757-942-1069",
"fax_number": "757-925-2213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "MARY",
"middle_name": "S",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0904002094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8904766",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPITMA FAMILY CARE",
"identifier": "O83006",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIGONBC/BS HEALTHKEEPERS",
"identifier": "270371",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.