| Larry Charles Stevens, Ph.d., P.c. | |
|
711 N Beaver St Flagstaff AZ 86001-3103 | |
| (928) 779-3783 | |
| (928) 773-1150 |
| Full Name | Larry Charles Stevens, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 711 N Beaver St, Flagstaff, Arizona |
| Authorized Official Name and Position | Larry Charles Stevens (PRESIDENT) |
| Authorized Official Contact | 9287793783 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Charles Stevens, Ph.d., P.c. 711 N Beaver St Flagstaff AZ 86001-3103 Ph: (928) 779-3783 | Larry Charles Stevens, Ph.d., P.c. 711 N Beaver St Flagstaff AZ 86001-3103 Ph: (928) 779-3783 |
| NPI Number | 1417197666 |
|---|---|
| Provider Enumeration Date | 03/01/2009 |
| Last Update Date | 03/01/2009 |
| Medicare PECOS PAC ID | 7517023245 |
|---|---|
| Medicare Enrollment ID | O20090304000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417197666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0004X | Psychologist - Health | 1177 (Arizona) | Primary |
| Provider Name | Larry C Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447371976 PECOS PAC ID: 3476573114 Enrollment ID: I20051128000206 |
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