Healthcare Provider Details

I. General information

NPI: 1841897790
Provider Name (Legal Business Name): STEPHANIE HUFFMAN LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E NC HIGHWAY 54 STE 320
DURHAM NC
27713-2490
US

IV. Provider business mailing address

1300 SLATEWORTH DR APT 1335
DURHAM NC
27703-6212
US

V. Phone/Fax

Practice location:
  • Phone: 919-907-3334
  • Fax: 919-907-3335
Mailing address:
  • Phone: 704-965-5426
  • Fax: 919-907-3335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP013178
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: