Provider Demographics
NPI:1023584679
Name:STEPHENS, ANNA MICHELLE (LPCC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MICHELLE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 CORPORATE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-5418
Mailing Address - Country:US
Mailing Address - Phone:859-223-1000
Mailing Address - Fax:859-223-1000
Practice Address - Street 1:870 CORPORATE DR STE 201
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5418
Practice Address - Country:US
Practice Address - Phone:859-223-1000
Practice Address - Fax:859-223-1000
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY244765101YM0800X
KY276180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100660290Medicaid