Provider Demographics
NPI:1376889923
Name:MORELL, STEPHANIE KATHARINE (MS, LPCA, LCASA, PVE)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:KATHARINE
Last Name:MORELL
Suffix:
Gender:F
Credentials:MS, LPCA, LCASA, PVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BREEZEWOOD DR
Mailing Address - Street 2:APT E
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8838
Mailing Address - Country:US
Mailing Address - Phone:252-902-5101
Mailing Address - Fax:
Practice Address - Street 1:2130 FOREST HILLS RD W
Practice Address - Street 2:STE A
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3680
Practice Address - Country:US
Practice Address - Phone:252-265-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NCLCASA 3056-A101YA0400X
NCLPCA- A9865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)