Individual
DR. NATHANAEL MARK STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP, LPC
Contact information
Practice address
650 WAVERLY RD, DIMONDALE, MI 48821-9642
(517) 507-6410
(517) 882-9969
Mailing address
2580 EATON RAPIDS RD, LANSING, MI 48911-6307
(517) 342-4253
(517) 882-9969
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401010248
MI
103TC1900X
Counseling Psychologist
Primary
6401010246
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912348475
—
MI
Enumeration date
07/12/2013
Last updated
08/08/2021
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