Healthcare Provider Details

I. General information

NPI: 1861830986
Provider Name (Legal Business Name): STEPPING STONES COMMUNITY RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S ARENDELL AVE
ZEBULON NC
27597-2809
US

IV. Provider business mailing address

PO BOX 2071
WENDELL NC
27591-2071
US

V. Phone/Fax

Practice location:
  • Phone: 919-269-9300
  • Fax:
Mailing address:
  • Phone: 919-269-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NEWTON
Title or Position: OWNER
Credential:
Phone: 919-434-2225