Individual
DERRICK KIRT STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
401 MOYE BLVD, GREENVILLE, NC 27834-2885
(252) 621-8180
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904007351
VA
1041C0700X
Clinical Social Worker
Primary
C010152
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007105517
—
VA
Enumeration date
04/01/2010
Last updated
07/21/2022
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