Healthcare Provider Details

I. General information

NPI: 1689170938
Provider Name (Legal Business Name): STABILITY COUNSELING AND ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 2ND ST STE 406
HENDERSON KY
42420-3174
US

IV. Provider business mailing address

230 2ND ST STE 406
HENDERSON KY
42420-3174
US

V. Phone/Fax

Practice location:
  • Phone: 812-550-5154
  • Fax: 855-718-2663
Mailing address:
  • Phone: 812-550-5154
  • Fax: 855-718-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3299
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3299
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN ROEHM
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 812-550-5154