Jacrissa S. Stevenson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

254354 Issued in KY

Practice address

4750 Hartland Pkwy Ste 248
Lexington, KY 40515-1561

Phone

(859) 436-9618

Fax

(859) 201-1361

NPI assigned

Sep 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668902400000",
    "number": "1629446760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 STONECROP DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405099054",
            "telephone_number": "859-533-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 HARTLAND PKWY STE 248",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151561",
            "telephone_number": "859-436-9618",
            "fax_number": "859-201-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1152 Stonecrop Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405099054",
            "country_code": "US",
            "telephone_number": "859-533-4470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JACRISSA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-07",
        "last_updated": "2022-11-20",
        "certification_date": "2022-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7345",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymonda Stevens, M.D.
• Sarah Stevens
• Scott Stevens, M.D.
• Tammy Lynn Stevens, BACHELOR OF SCIENCE
• Da'Keisha Stevenson, LPCC-S
• Sahara Shay Stevenson, LCSW
• Stewart Ventures LLC
• Anna Dee Stewart-Wilcox, CSW
• Aidan Michael Stewart
• Alicia Stewart, LCSW

• Clinical Social Worker in Lexington, KY
• Providers in Lexington, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.