Provider Demographics
NPI:1053185348
Name:STEVENS, HANNA PATRICE JORDAN (LCPC-C)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:PATRICE JORDAN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ANDREA ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250-6624
Mailing Address - Country:US
Mailing Address - Phone:207-504-0186
Mailing Address - Fax:
Practice Address - Street 1:9 BOWDOIN MILL IS
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1263
Practice Address - Country:US
Practice Address - Phone:207-504-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL7262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health