Provider Demographics
NPI:1124333026
Name:STEPHENS, ELIZABETH DUNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DUNN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3315
Mailing Address - Country:US
Mailing Address - Phone:704-754-4726
Mailing Address - Fax:704-754-4726
Practice Address - Street 1:117 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3315
Practice Address - Country:US
Practice Address - Phone:704-754-4726
Practice Address - Fax:704-754-4726
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0067291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007673Medicaid