Provider Demographics
NPI:1023551512
Name:GRIER, STEPHANIE JACKSON (MA, LCAS, CADC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JACKSON
Last Name:GRIER
Suffix:
Gender:F
Credentials:MA, LCAS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CASTLETON CT APT D
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2278
Mailing Address - Country:US
Mailing Address - Phone:704-968-0935
Mailing Address - Fax:
Practice Address - Street 1:1566 UNION RD STE B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5301
Practice Address - Country:US
Practice Address - Phone:704-968-0935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13273101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13273OtherNCSAPPB