Charles Stevens, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY4176 Issued in FL

Practice address

1127 S Patrick Dr
Suite 24
Satellite Beach, FL 32937-3939

Phone

(321) 773-1111

Fax

(321) 773-1692

NPI assigned

Jan 15, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Progressive Counseling Centers Inc

  dba Brevard Outpatient Alternative Treatment

  • Addiction (Substance Use Disorder) Counselor
  • Satellite Beach, FL
  • NPI 1275692204
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447301759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 MONDAVI DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S PATRICK DR",
            "address_2": "SUITE 24",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373939",
            "telephone_number": "321-773-1111",
            "fax_number": "321-773-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY4176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan John Spindler, D.C., ARNP.
• John Stadelman, LMHC
• Mark Stamand, RPH
• Stephanie Steger, M.A, CCC-SLP
• Claire Steininger, APRN, FNP-C
• Urszula Elizabeth Sund, ANP
• Surf Side Speech Specialists, LLC
• Surf Side Speech Therapy, LLC (Surf Side Speech Therapy for Adults, LLC)
• James Suthann, RCSW-I
• Theren Swinford III, ATC, LMT, LAT

• Clinical Child & Adolescent Psychologist in Satellite Beach, FL
• Providers in Satellite Beach, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.