Individual
JACOB STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, PLPC, CMHT
Contact information
Practice address
302 S SPRING ST STE A, TUPELO, MS 38804-4853
(662) 205-0098
Mailing address
5327 WYNTREE CV, TUPELO, MS 38801-8998
(662) 200-7279
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P-1347
MS
Other
Enumeration date
01/31/2017
Last updated
12/08/2025
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