Marc Edward Stevenson, LCSW 70064

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

70064 Issued in CA

Practice address

72 17TH St
San Diego, CA 92101-7670

Phone

(619) 233-8500

Fax

(619) 645-6479

NPI assigned

Apr 22, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1356795637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 MINNESOTA AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206116",
            "telephone_number": "619-233-8500",
            "fax_number": "619-645-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 17TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017670",
            "telephone_number": "619-233-8500",
            "fax_number": "619-645-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "MARC",
        "middle_name": "EDWARD",
        "credential": "LCSW 70064",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "70064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Denise Stevenson-Gaines, DNP
• Craig D. Stevenson, MD
• Hayley Elizabeth Stevenson, RBT
• Jennifer Stevenson, OTR/L
• Jennifer M Stevenson, LCSW
• Patricia A Stevenson, NP
• Reheia Alagao Stevenson, NP
• Stevie Stevenson
• Nicole Steverson, LCSW
• Vernetta Steverson

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.