Healthcare Provider Details

I. General information

NPI: 1912801499
Provider Name (Legal Business Name): JENNIFER STEWART HARRINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 S MEMORIAL DR
GREENVILLE NC
27834-2854
US

IV. Provider business mailing address

2814 DOC LOFTIN RD
AYDEN NC
28513-7568
US

V. Phone/Fax

Practice location:
  • Phone: 888-473-0904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC-29939
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: