Individual provider Active NPI

Katelyn Marie Stevens

  • Professional Counselor
  • Ashtabula, OH
National Provider Identifier
1679083059
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2303737 Issued in OH
Practice address
2801 C Court
Ashtabula, OH 44004-4577
Phone
(440) 998-4210
Fax
(440) 998-6489
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.2303737 OH Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2801 C Court
Ashtabula, OH 44004-4577

Mailing address

2801 C Court
Ashtabula, OH 44004-4577
Phone (440) 998-4210

Other identifiers 1

IdentifierTypeStateIssuer
0388473MedicaidOH

Other names 1

  • Katelyn Marie Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240226000656 OH Practitioner - Mental Health Counselor 0547605941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ravenwood Mental Health CenterGroup PAC ID 6901813922, 57 clinicians

Practice addresses (Care Compare)

12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone (440) 285-3568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2303737OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenwood Mental Health Center CurrentSince Feb 2, 2026 Accepting new patients
Ravenwood Mental Health Center CurrentSince Feb 2, 2026 Accepting new patients
Community Counseling Center of Ashtabula County Adolescent and Children Mental Health CurrentSince Jan 10, 2024 Accepting new patients

Locations

2801 C Ct
Ashtabula, OH 44004
Phone (440) 998-0722

12557 Ravenwood Dr
Concord Twp, OH 44024
Phone (440) 990-6104

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1679083059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 C COURT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044577",
            "telephone_number": "440-998-4210",
            "fax_number": "440-998-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 C COURT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044577",
            "telephone_number": "440-998-4210",
            "fax_number": "440-998-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303737",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0388473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "WILLIAMS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.