Provider Demographics
NPI:1558122408
Name:MARSHALL-BEY, STEPHANIE CHANEE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CHANEE
Last Name:MARSHALL-BEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7012
Mailing Address - Country:US
Mailing Address - Phone:984-800-6381
Mailing Address - Fax:
Practice Address - Street 1:800 N MANGUM ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2260
Practice Address - Country:US
Practice Address - Phone:919-683-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-28715101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)