Provider Demographics
NPI:1114813078
Name:COMBS, STEPHANIE CLARK (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CLARK
Last Name:COMBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 SUNNY SLOPE TRCE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1781
Mailing Address - Country:US
Mailing Address - Phone:859-420-8494
Mailing Address - Fax:
Practice Address - Street 1:168 E REYNOLDS RD STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1360
Practice Address - Country:US
Practice Address - Phone:859-212-3180
Practice Address - Fax:859-787-0531
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical