Provider Demographics
NPI:1871714972
Name:STEVENS, WILLIAM AARON (LPCC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:AARON
Last Name:STEVENS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 MCKEEHANS XING
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-9572
Mailing Address - Country:US
Mailing Address - Phone:606-524-9442
Mailing Address - Fax:
Practice Address - Street 1:575 MCKEEHANS XING
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-9572
Practice Address - Country:US
Practice Address - Phone:606-524-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1321101YM0800X
KY103886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11968464OtherCAQH
KY7100277580Medicaid