Healthcare Provider Details

I. General information

NPI: 1699190785
Provider Name (Legal Business Name): REBECCA ANN STEVENS LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CUNNINGHAM WAY
DANVILLE KY
40422-8339
US

IV. Provider business mailing address

540 COPPERFIELD DR
LAWRENCEBURG KY
40342-1929
US

V. Phone/Fax

Practice location:
  • Phone: 859-936-3492
  • Fax:
Mailing address:
  • Phone: 870-638-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberKY-1766
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number128432
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: