Healthcare Provider Details

I. General information

NPI: 1841124344
Provider Name (Legal Business Name): MEGAN RUTH STANFIELD LCMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

403 S HAWTHORNE RD
WINSTON SALEM NC
27103-3784
US

IV. Provider business mailing address

403 S HAWTHORNE RD
WINSTON SALEM NC
27103-3784
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-0855
  • Fax: 336-716-0822
Mailing address:
  • Phone: 336-716-0855
  • Fax: 336-716-0822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA23016
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23016
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: