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General NPI Number Information
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NPI Number | 1053539270
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Entity Type | Organization
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Legal Business Name | THOMAS AND STEVENS
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1517 NICHOLASVILLE RD STE. 400
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City | LEXINGTON
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State | KY
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Zip | 40503-1429
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Country | US
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Telephone | 859-276-5285
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Fax | 859-277-3513
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Provider Business Mailing Address
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Address Line | 1517 NICHOLASVILLE RD STE. 400
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City | LEXINGTON
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State | KY
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Zip | 40503-1429
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Country | US
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Telephone | 859-276-5285
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Fax | 859-277-3513
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Authorized Official
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Title or Position | PSYCOLOGIST
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Name | MR. JIMMY L. STEVENS
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Credential | M.S.
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Telephone | 859-276-5285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 406
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License Number State | KY
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