| Mrs Stephanie Evans, LLMSW | |
|
2601 13th St, Port Huron, MI 48060-6546 | |
| (810) 987-9100 | |
| (810) 987-9105 |
| Full Name | Mrs Stephanie Evans |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 20 Years |
| Location | 2601 13th St, Port Huron, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790835528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801-085773 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Shine Wellness Clinic Pllc | 3476825043 | 2 |
| Entity Name | Shine Wellness Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952822587 PECOS PAC ID: 3476825043 Enrollment ID: O20170816002293 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Stephanie Evans, LLMSW 2601 13th St, Port Huron, MI 48060-6546 Ph: (810) 987-9100 | Mrs Stephanie Evans, LLMSW 2601 13th St, Port Huron, MI 48060-6546 Ph: (810) 987-9100 |
Sara M Tavora, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 520 Superior St, Port Huron, MI 48060 Phone: 810-984-4202 Fax: 810-984-8896 | |
Heather Stewart, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Callie Gunn, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Brian Fanion, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mr. Robert Marshall Ii, LMSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Kristen M Azzinaro, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mrs. Deborah Louise Kokoszka, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 |