Healthcare Provider Details

I. General information

NPI: 1356245948
Provider Name (Legal Business Name): STEPHANIE GUMBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 EASTCHESTER DR STE 105
HIGH POINT NC
27265-1535
US

IV. Provider business mailing address

2100 PLEASANT LOOP
THOMASVILLE NC
27360-8366
US

V. Phone/Fax

Practice location:
  • Phone: 336-332-2277
  • Fax:
Mailing address:
  • Phone: 336-332-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23592
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: