Provider Demographics
NPI:1225727506
Name:TRIPP, STEPHANIE PARKER (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:PARKER
Last Name:TRIPP
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 1:1008 BULLARD CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6833
Mailing Address - Country:US
Mailing Address - Phone:919-338-4124
Mailing Address - Fax:
Practice Address - Street 1:1008 BULLARD CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6833
Practice Address - Country:US
Practice Address - Phone:919-338-4124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0187081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical