Provider Demographics
NPI:1699036327
Name:STEPHENS, KALYN MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:KALYN
Middle Name:MICHELLE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E. MAIN ST.
Mailing Address - Street 2:RESOURCE MANAGEMENT
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:815 E. 6TH ST.
Practice Address - Street 2:MEDICAL FAMILY THERAPY
Practice Address - City:TISHOMINGO
Practice Address - State:OK
Practice Address - Zip Code:73460
Practice Address - Country:US
Practice Address - Phone:580-371-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor