Individual provider Active NPI

Stephanie K Taylor-Edge, LPCC

  • Mental Health Counselor
  • Owensboro, KY
National Provider Identifier
1689101925
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
170605 Issued in KY
Practice address
920 Frederica St Ste 407
Owensboro, KY 42301-3079
Phone
(270) 689-0073
Fax
(270) 689-0083
NPI assigned
May 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 170605 KY Primary

Addresses

Primary practice location

920 Frederica St Ste 407
Owensboro, KY 42301-3079

Mailing address

338 Camden Cir
Owensboro, KY 42301-7949
Phone (270) 313-9898

Other identifiers 1

IdentifierTypeStateIssuer
05MedicaidKY

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

State licenses

LicenseStateTypeSpecialty
170605KYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1689101925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 CAMDEN CIR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017949",
            "telephone_number": "270-313-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 FREDERICA ST STE 407",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423013079",
            "telephone_number": "270-689-0073",
            "fax_number": "270-689-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-EDGE",
        "first_name": "STEPHANIE",
        "middle_name": "K",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "170605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.