Mark Wayne Stevens, LPC, CSAC II

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2006012732 Issued in MO

Practice address

12166 Old Big Bend Rd
Suite 100
Kirkwood, MO 63122-6844

Phone

(314) 452-6402

NPI assigned

Jun 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212883200000",
    "number": "1164681730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PEZOLD DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633047930",
            "telephone_number": "314-452-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD",
            "address_2": "SUITE 100",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226844",
            "telephone_number": "314-452-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MARK",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LPC, CSAC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-08",
        "last_updated": "2008-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "0794",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2006012732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Charles Stack, D.MIN
• Janet Elizabeth Staicoff, RD
• Brandon Cory Steele, DC
• Kristina Marie Steen, MSW
• Megan Huelsing Stein, AUD
• Nicole Manning Stewart, LCSW
• Kristen Stoff
• Christine Stojan, HLP, CT
• Benjamin Storey, BA
• Mary Carol Strauss-Barrett, LPC, LCSW

• Marriage & Family Therapist in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Marriage & Family Therapist in Missouri

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

Verify at the official NPI Registry.