MEDICARE: LAURA STEARNS MA, CRPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	CRPS.0101809.A	FL

General Provider Information

NPI Number	:	1174320410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA STEARNS MA, CRPS

Provider Business Mailing Address
First Line	:	1919 COVE POINT RD
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-3032
Country	:	US
Telephone Number	:
Fax Number	:	866-281-0390

Provider Business Practice Location Address
First Line	:	1919 COVE POINT RD
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-3032
Country	:	US
Telephone Number	:	386-753-4231
Fax Number	:	866-281-0390

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	03/03/2025

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