MEDICARE: MRS. STEPHANIE ANN EMMERSON MA, NCC, LPCA

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	101Y00000X	Counselor	A10356	NC

General Provider Information

NPI Number	:	1225590995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE ANN EMMERSON MA, NCC, LPCA

Provider Business Mailing Address
First Line	:	767 FALLSDALE CT
Second Line	:
City	:	STANLEY
State	:	NC
Zip	:	28164-7806
Country	:	US
Telephone Number	:	704-460-5535
Fax Number	:

Provider Business Practice Location Address
First Line	:	7834 GALWAY LN
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8600
Country	:	US
Telephone Number	:	704-460-5535
Fax Number	:

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

Provider Enumeration Date	:	04/02/2019
Last Update Date	:	04/02/2019

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