Provider Demographics
NPI:1801826946
Name:MCCAULEY, STEPHANIE LAMB (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LAMB
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:MCCAULEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:751 MADEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-6756
Mailing Address - Country:US
Mailing Address - Phone:828-685-1775
Mailing Address - Fax:828-685-4006
Practice Address - Street 1:751 MADEWOOD LN
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-6756
Practice Address - Country:US
Practice Address - Phone:828-685-1775
Practice Address - Fax:828-685-4006
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7401084Medicaid
NC3857OtherNC LICENSE NUMBER
NC1034YOtherBCBS OF NC PROVIDER