Provider Demographics
NPI:1518173012
Name:NANCE-ADAMS, STEPHANIE REBEKAH (MS,MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:REBEKAH
Last Name:NANCE-ADAMS
Suffix:
Gender:F
Credentials:MS,MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-7058
Mailing Address - Country:US
Mailing Address - Phone:919-215-8236
Mailing Address - Fax:919-550-3379
Practice Address - Street 1:2076 HWY 42 W.
Practice Address - Street 2:STE 220
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-550-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical