Organization
CAROLINA PROFESSIONAL MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK HODGE STEPHENS PLCSW (COOWNER)
(910) 272-9356
Entity
Organization
Contact information
Practice address
109 N COURT SQ, LUMBERTON, NC 28358-5554
(910) 272-9356
(910) 735-1945
Mailing address
109 N COURT SQ, LUMBERTON, NC 28358-5554
(910) 272-9356
(910) 735-1945
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0801X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SR001844
—
NC
Enumeration date
02/12/2009
Last updated
02/12/2009
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