Healthcare Provider Details

I. General information

NPI: 1033729124
Provider Name (Legal Business Name): GRAYCEE STEVENSON M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11242 STRANG LINE RD
LENEXA KS
66215-4039
US

IV. Provider business mailing address

11242 STRANG LINE RD
LENEXA KS
66215-4039
US

V. Phone/Fax

Practice location:
  • Phone: 913-343-1505
  • Fax:
Mailing address:
  • Phone: 913-662-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5809
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: