Individual provider Active NPI

Sha'Vonya M Stephens, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Pine Bluff, AR
National Provider Identifier
1508258542
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1361 Issued in TN
Practice address
620 S Laurel St
Pine Bluff, AR 71601-4859
Phone
(870) 534-4900
NPI assigned
Feb 27, 2015
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X ZZ
Addiction (Substance Use Disorder) Counselor 101YA0400X 1361 TN Primary

Addresses

Primary practice location

620 S Laurel St
Pine Bluff, AR 71601-4859

Mailing address

620 S Laurel St
Pine Bluff, AR 71601-4859

Other practice location 1

5511 Virginia Way Ste 300
Brentwood, TN 37027-7611
Phone (615) 994-1000

Other identifiers 2

IdentifierTypeStateIssuer
180635526MedicaidAR
Q097745MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250617001187 TN Practitioner - Mental Health Counselor 0042721037 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1361TNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
National Addiction Specialists LLC CurrentSince Apr 12, 2025 Accepting new patients

Locations

5511 Virginia Way
Ste 300
Brentwood, TN 37027
Phone (615) 692-1560

249 Central Park Ave
Ste 300161
Virginia Beach, VA 23462
Phone (615) 994-1000

Organizations & group practices 1

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": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1508258542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S LAUREL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S LAUREL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014859",
            "telephone_number": "870-534-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5511 Virginia Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277611",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "SHA'VONYA",
        "middle_name": "M",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ZZ",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180635526",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q097745",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.