Provider Demographics
NPI:1326846924
Name:STEPHENSON, LAUREN RUSSELL (LCMHC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RUSSELL
Last Name:STEPHENSON
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-8529
Mailing Address - Country:US
Mailing Address - Phone:336-575-7819
Mailing Address - Fax:
Practice Address - Street 1:503 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-8529
Practice Address - Country:US
Practice Address - Phone:336-575-7819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14432101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional