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General NPI Number Information
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NPI Number | 1023378254
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Entity Type | Organization
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Legal Business Name | STONEBRIDGE COUNSELING PLLC
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 1101 PEMBERTON HILL RD SUITE 103
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City | APEX
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State | NC
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Zip | 27502-3957
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Country | US
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Telephone | 919-434-6398
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Fax | 919-557-2089
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Provider Business Mailing Address
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Address Line | 1101 PEMBERTON HILL RD SUITE 103
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City | APEX
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State | NC
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Zip | 27502-3957
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Country | US
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Telephone | 919-434-6398
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Fax | 919-557-2089
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. KATHRYN SHELDON
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Credential |
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Telephone | 919-434-6398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C007423
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7714
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License Number State | NC
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