Active NPI
Keila L Stephens
- Mental Health Counselor
- Bogart, GA
National Provider Identifier
1396402178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- APC007701
- Practice address
- 2020 Cantrell LN
Bogart, GA 30622-1031 - Phone
- (706) 372-4305
- NPI assigned
- Nov 29, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | APC007701 | GA | Primary |
Addresses
Primary practice location
2020 Cantrell LN
Bogart, GA 30622-1031
Mailing address
2020 Cantrell LN
Bogart, GA 30622-1031
Phone (706) 372-4305
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | stephenskeila37@outlook.com |
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 |
|---|---|---|---|
| APC007701 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1396402178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 CANTRELL LN",
"city": "BOGART",
"state": "GA",
"postal_code": "306221031",
"telephone_number": "706-372-4305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 CANTRELL LN",
"city": "BOGART",
"state": "GA",
"postal_code": "306221031",
"telephone_number": "706-372-4305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "KEILA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-29",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "APC007701",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "stephenskeila37@outlook.com",
"affiliation": "N",
"address_1": "2020 Cantrell Ln",
"city": "Bogart",
"state": "GA",
"country_code": "US",
"postal_code": "306221031",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bogart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.