Larry Charles Stevens, PH.D., P.C.

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

1177 Issued in AZ

Legal business name

LARRY CHARLES STEVENS, PH.D., P.C.

Practice address

711 N Beaver St
Flagstaff, AZ 86001-3103

Phone

(928) 779-3783

Fax

(928) 773-1150

NPI assigned

Mar 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Larry Charles Stevens, PH.D.NPI 1447371976

Title

President

Phone

(928) 779-3783

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry Charles Stevens, PH.D.

  • Psychologist
  • Flagstaff, AZ
  • NPI 1447371976
  Medicare reassignment NPD Authorized official
• Steven R Patrick, PH.D.

  • Clinical Psychologist
  • Flagstaff, AZ
  • NPI 1396714192
  NPD (past)
• Susan K Patrick, PSY.D.

  • Psychologist
  • Flagstaff, AZ
  • NPI 1396895363
  NPD (past)
• Sumner Jay Sydeman, PH.D.

  • Clinical Psychologist
  • Flagstaff, AZ
  • NPI 1376755843
  NPD (past)

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

{
    "created_epoch": "1235865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235865600000",
    "number": "1417197666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013103",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013103",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY CHARLES STEVENS, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-01",
        "last_updated": "2009-03-01",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-779-3783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": "AZ",
            "license": "1177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery Lane Jr., AU.D.
• Chad Lange, MD
• Amanda Lanigan, LCSW
• Melany Tzintzitlini Lara
• Ashlie Larriva, LPC
• Larsen Chiropractic, Inc.
• Douglas Ray Larsen, D.C.
• Emily Jane Larsen, PA-C
• Kara Lee Larsen, D.O.
• Larson Rehabilitation Services, PLC

• Health Psychologist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Health Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2009; 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.