Individual provider Active NPI

Maximilian Martin Stepaniak

  • Mental Health Counselor
  • Bellevue, KY
National Provider Identifier
1447985155
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2606910 Issued in OH
Practice address
3011 Eden Ave
Unit 3B
Bellevue, KY 41073
Phone
(513) 910-7480
NPI assigned
Jul 18, 2022
Reactivated
Feb 28, 2023
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.2606910 OH Primary

Addresses

Primary practice location

3011 Eden Ave
Unit 3B
Bellevue, KY 41073

Mailing address

301 Eden Ave Unit 3B
Bellevue, KY 41073-1267

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

LicenseStateTypeSpecialty
E.2606910OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Group Home, LLC PastSince Jul 1, 2022 Accepting new patients
Phoenix Group Home, LLC PastSince Jul 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1447985155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EDEN AVE UNIT 3B",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 EDEN AVE",
            "address_2": "UNIT 3B",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "41073",
            "telephone_number": "513-910-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANIAK",
        "first_name": "MAXIMILIAN",
        "middle_name": "MARTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "deactivation_date": "2023-02-03",
        "reactivation_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2606910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.