Organization
PIVOTAL BREAKTHROUGH COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANICE STEPHENSON LCMHCA, LCASA, NCC (MENTAL HEALTH/SUBSTANCE USE COUNSEL)
(919) 418-1613
Entity
Organization
Contact information
Practice address
604 E FRONT ST # 1555, CLAYTON, NC 27520-2058
(919) 418-1613
Mailing address
PO BOX 1555, CLAYTON, NC 27528-1555
(919) 418-1613
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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