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NPI Code Detail

MEDICARE: STRIDE SERVICES LLC

MEDICARE: STRIDE SERVICES LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
41041C0700XClinical Social Worker
5251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1588279251
Entity Type Code : Organization
Provider Name (Legal Business Name) : STRIDE SERVICES LLC
Provider Business Mailing Address
First Line : 13000 S TRYON ST
Second Line : STF F #281
City : CHARLOTTE
State : NC
Zip : 28278-7652
Country : US
Telephone Number : 980-422-4468
Fax Number :
Provider Business Practice Location Address
First Line : 3117 WHITING AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-1648
Country : US
Telephone Number : 980-422-4468
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JENNIFER YVETTE HARRINGTON
Credential : DSW, LCSW
Telephone Number : 980-422-4468
Provider Enumeration Date : 09/10/2020
Last Update Date : 10/11/2022

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