MEDICARE: MR. STEVEN TREATT PONCE JR. LPC, LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	16791	NC
2	101YP2500X	Professional Counselor	9753	SC

General Provider Information

NPI Number	:	1639842438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN TREATT PONCE JR. LPC, LCMHC

Provider Business Mailing Address
First Line	:	7401 CARMEL EXECUTIVE PARK DR STE 210
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-0406
Country	:	US
Telephone Number	:	704-752-8414
Fax Number	:	704-544-1109

Provider Business Practice Location Address
First Line	:	2012 HIGHWAY 160 W STE 16
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8401
Country	:	US
Telephone Number	:	803-627-8478
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2021
Last Update Date	:	03/16/2026

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