Individual
AMY R. STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 819-6121
(757) 819-6149
Mailing address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 819-6121
(757) 819-6149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003288
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086778
SENTARA/OPTIMA
VA
01
—
276613
MAMSI-UNITED HEALTHCARE
VA
01
—
321005
ANTHEM TRIGON
VA
01
—
324100
FED HEALTH SERV TRICARE
VA
01
—
527433
VALUE OPTIONS
VA
Enumeration date
09/12/2005
Last updated
07/17/2013
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