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Organization
STACIE PETERSON, LCMHC, LPC, LLC
Active
Organization
STACIE PETERSON, LCMHC, LPC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE PETERSON (COUNSELOR)
(919) 346-3733
Entity
Organization
Contact information
Practice address
242 S BRAGG BLVD, SPRING LAKE, NC 28390-3929
(919) 346-3733
Mailing address
614 ELWOOD DR, DUNCAN, SC 29334-8995
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11188
LCMHC LICENSE NUMBER
NC
Enumeration date
11/03/2022
Last updated
11/03/2022
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