Provider Demographics
NPI:1336289891
Name:WAUGH, STELLA ELIZABETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:ELIZABETH
Last Name:WAUGH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 EASTOWNE DR STE 106
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2215
Mailing Address - Country:US
Mailing Address - Phone:919-547-9013
Mailing Address - Fax:919-490-9733
Practice Address - Street 1:800 EASTOWNE DR STE 106
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2215
Practice Address - Country:US
Practice Address - Phone:919-547-9013
Practice Address - Fax:919-490-9733
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0004031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2868781Medicare ID - Type Unspecified