Provider Demographics
NPI:1447060025
Name:STEVENS, VICTORIA LEANNE (LPC-A)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LEANNE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WIREGRASS WAY
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-4288
Mailing Address - Country:US
Mailing Address - Phone:785-845-5001
Mailing Address - Fax:
Practice Address - Street 1:1435 STUART ENGALS BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7311
Practice Address - Country:US
Practice Address - Phone:785-845-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health