Active NPI
Kyle R Stephenson, PH.D.
- Clinical Psychologist
- Cincinnati, OH
National Provider Identifier
1467818641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P.08315
- Practice address
- 3800 Victory Parkway
Elet Hall, RM 201
Cincinnati, OH 45207 - Phone
- (513) 745-3463
- NPI assigned
- Jan 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P.08315 | OH | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | 22426 | OR |
Addresses
Primary practice location
3800 Victory Parkway
Elet Hall, RM 201
Cincinnati, OH 45207
Mailing address
3800 Victory Pkwy
Cincinnati, OH 45207-1035
Phone (513) 745-3463
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22426 | OR | MD | Cognitive & Behavioral Psychologist |
| P.08315 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1467818641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 VICTORY PKWY",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452071035",
"telephone_number": "513-745-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 VICTORY PARKWAY",
"address_2": "ELET HALL, RM 201",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45207",
"telephone_number": "513-745-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "KYLE",
"middle_name": "R",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-04",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "P.08315",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "OR",
"license": "22426",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.