Individual
LANE STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
134 GRANDVIEW DR, BROOKSVILLE, KY 41004-8213
(606) 735-3611
(606) 735-2581
Mailing address
611 FOREST AVE, MAYSVILLE, KY 41056-1411
(606) 564-4016
(606) 564-8288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
394
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30608012
—
KY
Enumeration date
07/18/2006
Last updated
07/08/2007
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