Healthcare Provider Details

I. General information

NPI: 1497678437
Provider Name (Legal Business Name): STEADFAST HEALTH PROFESSIONAL SERVICES OF NORTH CAROLINA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3824 BARRETT DR STE 310
RALEIGH NC
27609-7220
US

IV. Provider business mailing address

3824 BARRETT DR STE 310
RALEIGH NC
27609-7220
US

V. Phone/Fax

Practice location:
  • Phone: 866-935-0936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DAVIS STEPHEN
Title or Position: CCO
Credential:
Phone: 479-422-1581