Healthcare Provider Details

I. General information

NPI: 1225160377
Provider Name (Legal Business Name): MARY STEWART SCHWEDER KALLENBACH LCMHCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY STEWART SCHWEDER

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 03/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 SILVER CREEK RD
MILL SPRING NC
28756-0093
US

IV. Provider business mailing address

2419 SILVER CREEK RD P.O. BOX 93
MILL SPRING NC
28756-0093
US

V. Phone/Fax

Practice location:
  • Phone: 828-388-0779
  • Fax: 828-894-7111
Mailing address:
  • Phone: 828-388-0779
  • Fax: 828-894-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number53220
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3220
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: