| Lisa M. Stephen Ph.d., Pc | |
|
89 Rye Cir Ste 1 South Burlington VT 05403-7632 | |
| (802) 355-9299 | |
| (802) 419-3399 |
| Full Name | Lisa M. Stephen Ph.d., Pc |
|---|---|
| Speciality | Psychologist |
| Location | 89 Rye Cir Ste 1, South Burlington, Vermont |
| Authorized Official Name and Position | Lisa Mary Stephen (PSYCHOLOGIST) |
| Authorized Official Contact | 8023559299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M. Stephen Ph.d., Pc Po Box 1034 Jericho VT 05465-1034 Ph: (802) 355-9299 | Lisa M. Stephen Ph.d., Pc 89 Rye Cir Ste 1 South Burlington VT 05403-7632 Ph: (802) 355-9299 |
| NPI Number | 1952799694 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 06/13/2019 |
| Medicare PECOS PAC ID | 2365746393 |
|---|---|
| Medicare Enrollment ID | O20160211000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952799694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 048-0000778 (Vermont) | Primary |
| Provider Name | Lisa M Stephen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699862342 PECOS PAC ID: 5890099824 Enrollment ID: I20160211000794 |
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