Jack Christopher Stephens

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

000000 Issued in WV

Practice address

1236 5TH Ave
Huntington, WV 25701-2207

Phone

(304) 544-6463

NPI assigned

Dec 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1467163865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 13TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013228",
            "telephone_number": "304-544-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 5TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012207",
            "telephone_number": "304-544-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JACK",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie A Stemple, MD
• Allycia Stennett, LPC
• Stephen B. Miller
• Stephens Therapy
• Erin Stephens
• Jarred Michael Stephens
• Melissa Dawn Stephens, MSW
• Sarah Nicole Stephens
• Haley Stephenson
• William B Stephenson, D.O.

• Peer Specialist in Huntington, WV
• Providers in Huntington, WV by specialty
• Peer Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.