Provider Demographics
NPI:1710133012
Name:KNOWLES, STEPHANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:GURR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-0098
Mailing Address - Country:US
Mailing Address - Phone:828-898-5465
Mailing Address - Fax:828-898-6140
Practice Address - Street 1:158 GRANDFATHER HOME FOR CHILDREN WAY
Practice Address - Street 2:HICKORY NUT GAP ROAD
Practice Address - City:BANNER ELK
Practice Address - State:NC
Practice Address - Zip Code:28604
Practice Address - Country:US
Practice Address - Phone:828-898-5465
Practice Address - Fax:828-898-6140
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0058211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical