Individual
KELLY L STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
106 SPRINGVIEW LN, SUMMERVILLE, SC 29485-8108
(843) 873-5063
(843) 851-2110
Mailing address
106 SPRINGVIEW LN, SUMMERVILLE, SC 29485-8108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
10191
SC
101YP2500X
Professional Counselor
7527
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
05/04/2015
Last updated
09/11/2024
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