Provider Demographics
NPI:1992356489
Name:STEPHENS, KAYLA DANIELLE (LPCA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DANIELLE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3044
Mailing Address - Street 2:
Mailing Address - City:WEST SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42564-3044
Mailing Address - Country:US
Mailing Address - Phone:606-687-2038
Mailing Address - Fax:606-200-3654
Practice Address - Street 1:250 BELMONT AVE STE 3
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2428
Practice Address - Country:US
Practice Address - Phone:606-772-1030
Practice Address - Fax:606-451-0558
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
KY244635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional