Provider Demographics
NPI:1598017733
Name:STEPPING STONE OF NORTH CAROLINA, LLC
Entity Type:Organization
Organization Name:STEPPING STONE OF NORTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF CONTRACT MANA
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-533-8762
Mailing Address - Street 1:1317 ROUTE 73 STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2202
Mailing Address - Country:US
Mailing Address - Phone:185-653-3876
Mailing Address - Fax:888-469-4994
Practice Address - Street 1:643 GREENWAY RD
Practice Address - Street 2:SUITE: L
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4819
Practice Address - Country:US
Practice Address - Phone:828-265-7078
Practice Address - Fax:888-469-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-095-046101YA0400X
NCNC-10072-M251S00000X, 332900000X
261QM2800X, 261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No332900000XSuppliersNon-Pharmacy Dispensing Site