Durant Vilisio Stephenson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18819 Issued in CA

Practice address

3732 Veteran Ave Apt 206
Los Angeles, CA 90034-7058

Phone

(917) 312-5188

NPI assigned

Jan 25, 2021

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

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1629668454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 VETERAN AVE APT 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900347058",
            "telephone_number": "917-312-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 VETERAN AVE APT 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900347058",
            "telephone_number": "917-312-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "DURANT",
        "middle_name": "VILISIO",
        "name_prefix": "Mr.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Stephens
• Taeana Mechalle Stephens
• Taylor Sayaka Azuma Stephens, RN
• Tracniece Stephens, LMFT 117202
• Ann-Marie Stephenson
• Kelli Stephenson
• Lialanda Stephenson
• Lorencita Stephenson, LCSW
• Margot Stephenson
• Riel Stephenson, ASW

• Speech-Language Pathologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.