Kia Tanisha Medley-Stephens, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC010330 Issued in PA

Practice address

2105 Coventry LN
Glen Mills, PA 19342-9434

Phone

(610) 620-5284

NPI assigned

Nov 29, 2019

Last updated

Nov 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Optimal Key Therapy LLC

  • Counselor
  • Glen Mills, PA
  • NPI 1962252437
  NPD Authorized official

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1811534605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 COVENTRY LN",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193429434",
            "telephone_number": "610-620-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 COVENTRY LN",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193429434",
            "telephone_number": "610-620-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY-STEPHENS",
        "first_name": "KIA",
        "middle_name": "TANISHA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-29",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Alesha McFillin, DPT
• Robert Daniel McGarrigle, D.O.
• Maryelisa McGinnis, RPH
• Stephanie Anne McKay
• Dominique Nicole McNeil, OT
• Susan Nancy Melton, MD
• Kenneth Mendel, MD
• Merakey Delaware County
• Danae Messick
• Michael S Ayes DDS and Associates Pennsylvania V, PC

• Professional Counselor in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.