Individual
STUART EDWARD SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHC, LCAS, CCS-I
Contact information
Practice address
3709 NASH ST NW, WILSON, NC 27896-1127
(252) 206-5799
Mailing address
523 BAYBERRY LN, WINTERVILLE, NC 28590-9170
(910) 234-4638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-25688
NC
101YM0800X
Mental Health Counselor
A15781
NC
Other
Enumeration date
09/01/2020
Last updated
09/01/2023
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