Provider Demographics
NPI:1275993289
Name:STEPHEY, BRYAN (LPC, NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:STEPHEY
Suffix:
Gender:M
Credentials:LPC, NCC, CCMHC
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 172
Mailing Address - Street 2:
Mailing Address - City:CULLODEN
Mailing Address - State:WV
Mailing Address - Zip Code:25510-0172
Mailing Address - Country:US
Mailing Address - Phone:304-760-9945
Mailing Address - Fax:304-397-0896
Practice Address - Street 1:3847 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9820
Practice Address - Country:US
Practice Address - Phone:304-760-9945
Practice Address - Fax:304-397-0896
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YA0400X
WV2803101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)