Individual
MR. CHARLES LUCAS STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMLP, LCP
Contact information
Practice address
11200 LARIAT WAY, DODGE CITY, KS 67801-7328
(620) 225-0276
(620) 225-0276
Mailing address
900 W BROADWAY ST, NEWTON, KS 67114-2037
(316) 283-1950
(316) 283-9540
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0136
KS
103T00000X
Psychologist
0141
KS
103TP2701X
Group Psychotherapy Psychologist
Primary
0136
KS
103TP2701X
Group Psychotherapy Psychologist
0141
KS
Other
Enumeration date
03/20/2007
Last updated
09/11/2025
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