| Stephens Behavior Consulting, Llc | |
|
320 Main St Shelbyville KY 40065-1026 | |
| (502) 633-1315 | |
| (502) 633-1316 |
| Full Name | Stephens Behavior Consulting, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 320 Main St, Shelbyville, Kentucky |
| Authorized Official Name and Position | Kyle Stephens (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5026331315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephens Behavior Consulting, Llc Po Box 516 Shelbyville KY 40066-0516 Ph: (502) 633-1315 | Stephens Behavior Consulting, Llc 320 Main St Shelbyville KY 40065-1026 Ph: (502) 633-1315 |
| NPI Number | 1023415692 |
|---|---|
| Provider Enumeration Date | 11/26/2014 |
| Last Update Date | 11/26/2014 |
| Medicare PECOS PAC ID | 1254672538 |
|---|---|
| Medicare Enrollment ID | O20190415002007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023415692 | NPI | - | NPPES |
| 7100250830 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | KY-0060 (Kentucky) | Primary |
| 251S00000X | Community/behavioral Health | 1519 (Kentucky) | Secondary |
| Provider Name | Jennifer Ann Stephens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780699371 PECOS PAC ID: 7416298708 Enrollment ID: I20240104003062 |
| Provider Name | Krista R. Vavro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912024498 PECOS PAC ID: 0345688859 Enrollment ID: I20240403001705 |
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