Individual
MR. JAMES ALLEN STEVERSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4000 BREEZEPORT WAY, SUFFOLK, VA 23435-3739
(175) 773-9026
Mailing address
4000 BREEZEPORT WAY, SUFFOLK, VA 23435-3739
(757) 739-0269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013084
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904013084
LCSW
VA
Enumeration date
08/09/2021
Last updated
08/09/2021
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