Healthcare Provider Details

I. General information

NPI: 1700402054
Provider Name (Legal Business Name): STEPHANIE LEEANN DOWNS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE L404
LEXINGTON KY
40536-9010
US

IV. Provider business mailing address

2250 THUNDERSTICK DR
LEXINGTON KY
40505-9010
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5643
  • Fax: 859-323-3795
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number254837
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number257632
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: