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General NPI Number Information
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NPI Number | 1023705472
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Entity Type | Individual
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Provider Name | STEPHANIE NICOLE WAINWRIGHT LCAS
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Gender | Female
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 696 S SCALES ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5024
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Country | US
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Telephone | 833-510-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-29054
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 26562
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License Number State | NC
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