Provider Demographics
NPI:1811596992
Name:KILLEN, STEPHEN (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:KILLEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 ROYAL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2859
Mailing Address - Country:US
Mailing Address - Phone:256-585-4586
Mailing Address - Fax:
Practice Address - Street 1:100 CENTERVIEW DR STE 150
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-3749
Practice Address - Country:US
Practice Address - Phone:205-807-5372
Practice Address - Fax:205-413-8789
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional