Provider Demographics
NPI:1205503588
Name:MEFFORD, STEVIE LEA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:LEA
Last Name:MEFFORD
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:GHENT
Mailing Address - State:KY
Mailing Address - Zip Code:41045-2530
Mailing Address - Country:US
Mailing Address - Phone:502-525-6938
Mailing Address - Fax:
Practice Address - Street 1:1130 BOONE AIRE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1202
Practice Address - Country:US
Practice Address - Phone:859-282-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-21-52718103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst