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Organization
SOUTHPORT COUNSELING SERVICES, PLLC
Active
Organization
SOUTHPORT COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYMRA F STEWART LCSW (PROVIDER/OWNER)
(828) 385-1889
Entity
Organization
Contact information
Practice address
3960 EXECUTIVE PARK BLVD STE 3, SOUTHPORT, NC 28461-8184
(910) 854-0371
(910) 854-0371
Mailing address
3960 EXECUTIVE PARK BLVD STE 3, SOUTHPORT, NC 28461-8184
(910) 854-0371
(910) 854-0371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79895
BCBSNC
NC
Enumeration date
10/17/2018
Last updated
10/17/2018
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