Sean Edward Stevens, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY6478 Issued in FL

Practice address

1103 Fortune Ave
Panama City, FL 32401-1831

Phone

(850) 769-6188

Fax

(850) 769-1261

NPI assigned

Dec 19, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sean E. Stevens, PH.D. P.C.

  • Clinical Psychologist
  • Omaha, NE
  • NPI 1962952390
  Medicare reassignment NPD Authorized official
• Suzette Smith LCSW Inc

  • Clinical Social Worker
  • Panama City, FL
  • NPI 1023339579
  NPD (past)
• Rizzo & Associates, PC

  • Clinical Psychologist
  • Omaha, NE
  • NPI 1306802806
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508929324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 ILEX CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054854",
            "telephone_number": "850-271-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 FORTUNE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011831",
            "telephone_number": "850-769-6188",
            "fax_number": "850-769-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SEAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54727",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catharine H Stephenson, A.R.N.P.
• Steps to Serenity
• Steven E Goodwiller MD PA
• Steven L Mullis MD PA
• Nathan Stevens
• Velma Penermon Stevens, MSW, ACSW, LCSW
• Benjamin Schafer Stevenson, APRN
• Cristina E Stevenson, CNM
• Ariyana Stewart, RBT
• Lisa Adams Stewart, CCC-SLP

• Psychologist in Panama City, FL
• Providers in Panama City, FL by specialty
• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.