Provider Demographics
NPI:1306005269
Name:STEBBINS, KATHLEEN FORD (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FORD
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 LUCAS ST
Mailing Address - Street 2:SUITE D1
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4381
Mailing Address - Country:US
Mailing Address - Phone:843-709-6553
Mailing Address - Fax:
Practice Address - Street 1:217 LUCAS ST
Practice Address - Street 2:SUITE D1
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4381
Practice Address - Country:US
Practice Address - Phone:843-709-6553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178004774101YP2500X
SC5674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional