Provider Demographics
NPI:1245314186
Name:STIRSMAN, DEVONNE (LPCC, LCADC)
Entity type:Individual
Prefix:
First Name:DEVONNE
Middle Name:
Last Name:STIRSMAN
Suffix:
Gender:F
Credentials:LPCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 3RD ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4135
Mailing Address - Country:US
Mailing Address - Phone:270-977-3708
Mailing Address - Fax:270-228-0341
Practice Address - Street 1:100 W 3RD ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4135
Practice Address - Country:US
Practice Address - Phone:270-977-3708
Practice Address - Fax:270-228-0341
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY165561101YA0400X
KY163596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100391250Medicaid