Individual
KELLY R STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1102 SMITH AVE, SUITE K, THOMASVILLE, GA 31792-5739
(229) 227-2429
(229) 225-4374
Mailing address
2131 WESLEY CT, TALLAHASSEE, FL 32303-2453
(850) 459-6961
(229) 225-4374
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004622
GA
1041C0700X
Clinical Social Worker
SW10550
FL
Other
Enumeration date
05/21/2012
Last updated
05/24/2012
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