Provider Demographics
NPI:1942017108
Name:STEVENS, BRIANNA REIGN (CDCA)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:REIGN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 ALEXANDRIA PIKE APT 2
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1122
Mailing Address - Country:US
Mailing Address - Phone:937-271-2677
Mailing Address - Fax:
Practice Address - Street 1:1990 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-1122
Practice Address - Country:US
Practice Address - Phone:193-727-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.190769101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)