Provider Demographics
NPI:1275500761
Name:STEPHENS, PAIGE ARENA (LCAS, LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ARENA
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LCAS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:101 COLVARD ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9797
Practice Address - Country:US
Practice Address - Phone:336-246-4542
Practice Address - Fax:336-246-2364
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC931101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1413COtherBC/BS
NC1275500761Medicaid