NPI Code Detail JSON Logo

1164647681 NPI number — STEPHANIE A DVORAK LCMHC-S/LCAS

NPI Number: 1164647681
Health Care Provider/Practitioner: STEPHANIE A DVORAK LCMHC-S/LCAS

Information about “1164647681” NPI (STEPHANIE A DVORAK LCMHC-S/LCAS) exists in 1164647681 in HTML format HTML  |  1164647681 in plain Text format TXT  |  1164647681 in PDF (Portable Document Format) PDF  |  1164647681 in an XML format XML  formats.

NPI Number : 1164647681 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164647681",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DVORAK",
    "FirstName": "STEPHANIE",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCMHC-S/LCAS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1096",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MARION",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28752-1096",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "828-559-9595",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "204 CHARLOTTE HWY STE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASHEVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28803-8681",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "828-333-5708",
    "PracticeLocationAddressFaxNumber": "828-484-1025",
    "EnumerationDate": "04/17/2007",
    "LastUpdateDate": "10/02/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "4988",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "4988",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "4988",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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