Healthcare Provider Details

I. General information

NPI: 1568397511
Provider Name (Legal Business Name): WILLOW GRACE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 CULVER LN
STEARNS KY
42647-6409
US

IV. Provider business mailing address

85 CULVER LN
STEARNS KY
42647-6409
US

V. Phone/Fax

Practice location:
  • Phone: 606-310-9344
  • Fax:
Mailing address:
  • Phone: 606-310-9344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HEATHER STEPHENS
Title or Position: PSYCHIATRIC MENTAL HEALTH NP
Credential: PMHNP-BC
Phone: 606-310-9344