Provider Demographics
NPI:1912588922
Name:STEVENS, MCKAYLA NICOLE (MED LPC)
Entity Type:Individual
Prefix:
First Name:MCKAYLA
Middle Name:NICOLE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 N CANTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3838
Mailing Address - Country:US
Mailing Address - Phone:330-794-4254
Mailing Address - Fax:330-794-4262
Practice Address - Street 1:87 N CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3838
Practice Address - Country:US
Practice Address - Phone:330-794-4254
Practice Address - Fax:330-794-4262
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHC.2204034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health