Healthcare Provider Details

I. General information

NPI: 1639370208
Provider Name (Legal Business Name): JENNIFER M. STIMPSON M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 STONY POINT RD
SHELBY NC
28150-9602
US

IV. Provider business mailing address

1907 STONY POINT RD
SHELBY NC
28150-9602
US

V. Phone/Fax

Practice location:
  • Phone: 704-435-9521
  • Fax: 704-435-5777
Mailing address:
  • Phone: 704-435-9521
  • Fax: 704-435-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3907
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: