| Doctor Name: | KERRY T STEPHENS |
| NPI Number: | 1073813432 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | E-500224 |
| License Number: | E-500224 |
| Business Practice Address: | 50 Greenwood Ln Springboro, OH - 450663033 |
| Business Phone Number: | 9377461154 |
| Business Fax Number: | 9377468523 |
| Mailing Address: | 975 Kingsview Drive, Suite 400 LEBANON |
| State: | OH |
| Postal Code: | 450368336 |
| Phone Number: | 5132287854 |
| Fax Number: | 5132287848 |
| NPI Enumeration Date: | 11/01/2010 |
| NPI Last Update Date: | 12/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E-500224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |