Provider Demographics
NPI:1114683158
Name:HOOVER, STEPHANIE ALEXIS (LCSWA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALEXIS
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 CHALKSTONE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-4579
Mailing Address - Country:US
Mailing Address - Phone:336-549-1448
Mailing Address - Fax:
Practice Address - Street 1:635 COX RD STE B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3441
Practice Address - Country:US
Practice Address - Phone:704-691-7561
Practice Address - Fax:704-691-7563
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0165901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical