Healthcare Provider Details

I. General information

NPI: 1083320576
Provider Name (Legal Business Name): BEYOND PLATEAUS PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 REGENCY PKWY
CARY NC
27518-8549
US

IV. Provider business mailing address

1047 W STERLINGTON PL
APEX NC
27502-8938
US

V. Phone/Fax

Practice location:
  • Phone: 919-805-2597
  • Fax:
Mailing address:
  • Phone: 919-805-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE HENRY
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 919-805-2597