Individual provider Active NPI

Tasha J Lewis Stevens, LCSW

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton, IN
National Provider Identifier
1487605606
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71010158A Issued in IN
Practice address
777 S Main St
Suite 100
Clinton, IN 47842-2493
Phone
(765) 828-1003
Fax
(765) 828-1030
NPI assigned
May 12, 2006
Last updated
Jul 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71010158A IN Primary
Clinical Social Worker 1041C0700X 34004589 IN

Addresses

Primary practice location

777 S Main St
Suite 100
Clinton, IN 47842-2493

Mailing address

PO Box 344
Clinton, IN 47842-0344
Phone (765) 828-1003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817001103 IN Practitioner - Nurse Practitioner 6709917511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 S Main St
Clinton, IN 47842-2493
Phone (765) 828-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004589INMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Professionals Community Health Center, Inc. CurrentSince Jul 15, 2020 Accepting new patients

Locations

703 W Park St
Cayuga, IN 47928
Phone (765) 492-9042

777 S Main St
Ste 100
Clinton, IN 47842
Phone (765) 828-1003

1530 N 7th St
Ste 201
Terre Haute, IN 47807
Phone (812) 238-7631

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1487605606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478420344",
            "telephone_number": "765-828-1003",
            "fax_number": "765-828-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478422493",
            "telephone_number": "765-828-1003",
            "fax_number": "765-828-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS STEVENS",
        "first_name": "TASHA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71010158A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IN

Sources for this page

Verify at the official NPI Registry.