Individual provider Active NPI

Kourtney G Stevens, LCSW

  • Clinical Social Worker
  • Mount Sterling, KY
National Provider Identifier
1376083980
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255192 Issued in KY
Practice address
209 N Maysville St Ste 200
Mount Sterling, KY 40353-1179
Phone
(859) 404-7686
Fax
(859) 498-8160
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 255192 KY Primary

Addresses

Primary practice location

209 N Maysville St Ste 200
Mount Sterling, KY 40353-1179

Mailing address

236 W Main St
Mount Sterling, KY 40353-1348
Phone (859) 404-7686

Other practice location 1

300 Foxglove Dr
MT Sterling, KY 40353-9769
Phone (606) 329-8588

Other identifiers 1

IdentifierTypeStateIssuer
7100694150MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027000845 KY Practitioner - Clinical Social Worker 6901226281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Health Solutions IncGroup PAC ID 9436301686, 59 clinicians

Practice addresses (Care Compare)

633 Maysville Rd
Mount Sterling, KY 40353-9767
Phone (859) 404-7686

635 N Maysville St
Suite a
Mount Sterling, KY 40353-9767
Phone (859) 498-2323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255192KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Health Solutions, Inc CurrentSince Nov 16, 2020 Accepting new patients
Pathways Inc CurrentSince Sep 9, 2020 Accepting new patients
Sterling Health Solutions Inc CurrentSince Nov 16, 2020 Accepting new patients
Pathways, Inc CurrentSince Sep 9, 2020 Accepting new patients

Locations

3701 Landsdowne Dr
Ashland, KY 41102
Phone (606) 324-3005

209 N Maysville St
Ste 200
Mt Sterling, KY 40353
Phone (859) 404-4686

300 Foxglove Dr
Mt Sterling, KY 40353
Phone (800) 562-8909

633 Maysville Rd
Mt Sterling, KY 40353
Phone (859) 274-4595

103 Commonwealth Dr
Mt Sterling, KY 40353
Phone (859) 498-7715

44 Water St
Owingsville, KY 40360
Phone (606) 674-9776

Interoperability endpoints

  • Direct secure messaging: kourtney.stevens.1@25737.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1376083980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 W MAIN ST",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531348",
            "telephone_number": "859-404-7686",
            "fax_number": "859-274-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N MAYSVILLE ST STE 200",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403531179",
            "telephone_number": "859-404-7686",
            "fax_number": "859-498-8160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Foxglove Dr",
            "address_purpose": "LOCATION",
            "city": "MT Sterling",
            "state": "KY",
            "postal_code": "403539769",
            "country_code": "US",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KOURTNEY",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100694150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Sterling, KY

Sources for this page

Verify at the official NPI Registry.