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Individual

JENNA STAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-A, LCAS-A

Contact information

Practice address
503 COVIL AVE STE 102, WILMINGTON, NC 28403-2683
(910) 995-4154
Mailing address
421 FAYETTEVILLE ST STE 1100, RALEIGH, NC 27601-3000
(877) 418-2978
(866) 500-2186

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29080
NC
106S00000X
Behavior Technician
NC

Other

Enumeration date
12/03/2020
Last updated
04/13/2024
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