Individual
MRS. JACRISSA S. STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4750 HARTLAND PKWY STE 248, LEXINGTON, KY 40515-1561
(859) 436-9618
(859) 201-1361
Mailing address
1152 STONECROP DR, LEXINGTON, KY 40509-9054
(859) 533-4470
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254354
KY
1041C0700X
Clinical Social Worker
7345
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
09/07/2015
Last updated
11/20/2022
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