Provider Demographics
NPI:1942597240
Name:MEADOWS, NANCY STEPHENS
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:STEPHENS
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:STEPHENS
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,LCAS,CSI
Mailing Address - Street 1:315 HUGHES ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2907
Mailing Address - Country:US
Mailing Address - Phone:336-272-7079
Mailing Address - Fax:336-275-3038
Practice Address - Street 1:315 HUGHES ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2907
Practice Address - Country:US
Practice Address - Phone:336-272-7079
Practice Address - Fax:336-275-3038
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP2500X101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103578Medicaid