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KESSA MYSTIQUE STEPHENSON-TAYLOR AA, BA
NPI 1255833885
Counselor - Mental Health in Longview, WA

Active since February 28, 2018PECOS Enrolled
1430 16TH AVE, LONGVIEW, WA 98632(360) 799-4556 Get Directions Write a Review

NPPES record last updated: January 8, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2020, Mar 12, 2018, Feb 28, 2018 (3 updates tracked since 2018).

About Kessa Mystique Stephenson-taylor Aa, Ba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KESSA MYSTIQUE STEPHENSON-TAYLOR AA, BA (NPI 1255833885) is an individual mental health provider in Longview, Washington and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1255833885
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKESSA MYSTIQUE STEPHENSON-TAYLORCredential: AA, BA
Location Address1430 16TH AVELongview, WA 98632-2901
Mailing Address245 Calvin RdCinebar, WA 98533-9700 · (360) 520-6529
Phone(360) 799-4556
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateFebruary 28, 2018
Last NPPES UpdateJanuary 8, 20203 updates tracked since enumeration
✔ NPI 1255833885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1430 16TH AVE, Longview, WA 98632
Open in Google Maps ↗

Other Names 1

Former Name (1)Kessa Mystique Shattuck Aa, Ba

Secondary Practice Locations 2

Location 13857 Martin Way EOlympia, WA 98506 · Phone (360) 704-7170
Location 24804 Lacey Blvd SE Ste ALacey, WA 98503-5733 · Phone (360) 799-5782

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kessa Mystique Stephenson-taylor Aa, Ba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890145833
PECOS Enrollment IDI20240103001224
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PHILIP JAMES MIOLLIS DDS
Dentist
1430 16TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 425-2520
VICTORY HEALTHCARE LLC
Family Medicine
1430 16TH AVE
LONGVIEW, WA 98632
Cowlitz County (253) 331-2381

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kessa Stephenson-taylor's NPI number?

The NPI number for Kessa Stephenson-taylor is 1255833885. It was assigned to this individual provider in the NPPES registry on February 28, 2018. The provider is also known as Kessa Mystique Shattuck Aa, Ba.

Where is Kessa Stephenson-taylor located?

Kessa Stephenson-taylor practices at 1430 16th Ave, Longview, WA 98632. The listed phone number is (360) 799-4556.

What is Kessa Stephenson-taylor's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kessa Stephenson-taylor enrolled in Medicare?

Yes. Kessa Stephenson-taylor is registered in the Medicare PECOS enrollment system.

What insurance does Kessa Stephenson-taylor accept?

Health plans from Kaiser Permanente, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan and UnitedHealthcare list Kessa Stephenson-taylor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kessa Stephenson-taylor was last updated on January 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.