Provider Demographics
NPI:1285012534
Name:PIERCE, STEPHANIE GEORGIA (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GEORGIA
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4138 MEDFORD DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-4516
Mailing Address - Country:US
Mailing Address - Phone:704-786-3114
Mailing Address - Fax:
Practice Address - Street 1:714 SOUTH MAIN STREET
Practice Address - Street 2:S&H YOUTH AND ADULT SERVICES, INC.
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-603-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional