Kylie Deanna Stough, LPC/MHSP
Counselor, Professional in Oak Ridge, TN. Individual provider (NPI-1).
NPI number1205410016
StatusActive
Last updated in NPPESMay 7, 2021
Details
- NPI
- 1205410016
- Entity type
- Individual (NPI-1)
- Name
- Kylie Deanna Stough
- Credential
- LPC/MHSP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 7, 2021
- Certification date
- May 7, 2021
- Last updated
- May 7, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 4660 | TN | Yes |
| 163WG0000X | Registered Nurse, General Practice | 228872 | TN |
Practice location
240 W Tyrone RdOak Ridge, TN 37830-6517
Phone 865-481-6175
Mailing address
12501 Choto Mill LnKnoxville, TN 37922-0615
Phone 865-392-1600
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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