Individual
EVONNE LANAE STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LCPC
Contact information
Practice address
600 E MAIN ST, SALEM, IL 62881-2933
(618) 740-0726
(618) 740-0727
Mailing address
600 E MAIN ST, SALEM, IL 62881-2933
(618) 740-0726
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
180008660
IL
101YS0200X
School Counselor
—
—
Other
Enumeration date
10/15/2010
Last updated
08/21/2014
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