Active NPI
Debra K Stephens, LSW
- Clinical Social Worker
- Wayne, WV
National Provider Identifier
1093804072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- AP00455073
- Practice address
- 145 Kenova Ave
Wayne, WV 25570 - Phone
- (304) 525-7851
- Fax
- (304) 525-1073
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | AP00455073 | WV | Primary |
Addresses
Primary practice location
145 Kenova Ave
Wayne, WV 25570
Mailing address
RR 2 Box 2449
Wayne, WV 25570-9762
Phone (304) 525-7851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP00450373 | Other | WV | LSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP00455073 | WV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prestera Center for Mental Health Services Inc | Past | Accepting new patients | |
| Prestera Center for Mental Health Services Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Barboursville, WV
- NPI 1356336903
-
- Primary Care Clinic/Center
- Huntington, WV
- NPI 1992394860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093804072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 2 BOX 2449",
"city": "WAYNE",
"state": "WV",
"postal_code": "255709762",
"telephone_number": "304-525-7851",
"fax_number": "304-525-1073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 KENOVA AVE",
"city": "WAYNE",
"state": "WV",
"postal_code": "25570",
"telephone_number": "304-525-7851",
"fax_number": "304-525-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "DEBRA",
"middle_name": "K",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "AP00455073",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LSW",
"identifier": "AP00450373",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.