Individual
JOANNA LISA VON STADEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA, NCC
Contact information
Practice address
9541 JULIAN CLARK AVE STE 100, HUNTERSVILLE, NC 28078-3484
(980) 358-1366
Mailing address
9541 JULIAN CLARK AVE STE 100, HUNTERSVILLE, NC 28078-3484
(980) 358-1366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A16656
NC
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
951767480P
—
NC
Enumeration date
09/02/2021
Last updated
01/29/2022
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