=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649135286
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA STOGNER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/17/2025
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 BELMONT AVE
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42501-2419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-687-2038
-----------------------------------------------------
Fax | 606-200-3654
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 BELMONT AVE
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42501-2419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-687-2038
-----------------------------------------------------
Fax | 606-200-3654
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 258697
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------