Kenneth J Stephenson, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

4811 Issued in NC

Practice address

4389 Indian Trail Fairview Rd Ste 23
Indian Trail, NC 28079-9649

Phone

(704) 526-9905

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Walgren Counseling, PLLC

  • Clinical Social Worker
  • Matthews, NC
  • NPI 1235422742
  Medicare reassignment NPD
• Insight Counseling & Psychotherapy Services

  • Professional Counselor
  • Matthews, NC
  • NPI 1841445418
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1902023252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DUTCHMANS MEADOW DR",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281203004",
            "telephone_number": "704-951-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 INDIAN TRAIL FAIRVIEW RD STE 23",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280799649",
            "telephone_number": "704-526-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "4811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11871065",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE HPSO",
            "identifier": "0312590692",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9727178",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stalls Medical, Inc.
• John Colter Stanton, MD
• Walter Kevin Steele, EMT P120704
• Stegall Counseling PLLC
• Lauren Stegall, LCMHC, NCC, LRT/CTRS
• Bradley Sean Stevenson
• Judith Marie Steverson
• Summit Health Solutions, PLLC (Indian Trail Chiropractic and Rehabilitation)
• Morgan Sunderland
• Shelli Swail, RPH

• Counselor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.