Provider Demographics
NPI:1790069896
Name:STEPHENS COUNSELING AND CONSULTING SERVICES, PLLC
Entity Type:Organization
Organization Name:STEPHENS COUNSELING AND CONSULTING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-277-2239
Mailing Address - Street 1:211 PAGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4884
Mailing Address - Country:US
Mailing Address - Phone:704-277-2239
Mailing Address - Fax:704-889-3013
Practice Address - Street 1:219 MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-7528
Practice Address - Country:US
Practice Address - Phone:704-277-2239
Practice Address - Fax:704-889-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty