Provider Demographics
NPI:1306520143
Name:CLINE, STEPHEN SCOTT
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SCOTT
Last Name:CLINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 KEG CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2412
Mailing Address - Country:US
Mailing Address - Phone:910-987-9172
Mailing Address - Fax:
Practice Address - Street 1:4625 KEG CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2412
Practice Address - Country:US
Practice Address - Phone:910-987-9172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker