Kelly R Stevenson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004622 Issued in GA

Practice address

1102 Smith Ave
Suite K
Thomasville, GA 31792-5739

Phone

(229) 227-2429

Fax

(229) 225-4374

NPI assigned

May 21, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1215297601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 WESLEY CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323032453",
            "telephone_number": "850-459-6961",
            "fax_number": "229-225-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SMITH AVE",
            "address_2": "SUITE K",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925739",
            "telephone_number": "229-227-2429",
            "fax_number": "229-225-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10550",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alethia Cunningham Stephens
• Amy M Stephens, O.D.
• Benjamin Stephenson, OTR/L, CHT
• Jennifer Michelle Stephenson, OTR/L
• Meredith Stevens, CRNA
• Bionca Juannay Stewart, LCSW
• Eduardo Jose Stincer, M.D.
• Timothy Scott Stinson, FNP
• Desire' S Stokes, CCC-SLP
• Karson Stone

• Clinical Social Worker in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.