Provider Demographics
NPI:1609460567
Name:STAFFORD & ASSOCIATES COUNSELING, PLLC
Entity Type:Organization
Organization Name:STAFFORD & ASSOCIATES COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCNI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:704-534-5997
Mailing Address - Street 1:121 ROLLING HILL RD STE 225
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8861
Mailing Address - Country:US
Mailing Address - Phone:704-534-5997
Mailing Address - Fax:
Practice Address - Street 1:121 ROLLING HILL RD STE 225
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8861
Practice Address - Country:US
Practice Address - Phone:704-534-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1720451628OtherNPI