MEDICARE: CARLY STIMSON

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1588487482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY STIMSON

Provider Business Mailing Address
First Line	:	307 INTERNATIONAL CIR STE 100
Second Line	:
City	:	HUNT VALLEY
State	:	MD
Zip	:	21030-1387
Country	:	US
Telephone Number	:	410-667-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 HENDERSON DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-5246
Country	:	US
Telephone Number	:	910-353-2161
Fax Number	:

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

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	04/13/2026

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Directions to “ CARLY STIMSON ” Practice Location

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