Provider Demographics
NPI:1558092411
Name:WEISENTHAL, STEPHANIE (LCMHC, LCAS, CSI)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WEISENTHAL
Suffix:
Gender:F
Credentials:LCMHC, LCAS, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MOUNTAIN VIEW ANX
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762-6216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 42
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:NC
Practice Address - Zip Code:28770-0042
Practice Address - Country:US
Practice Address - Phone:828-337-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17058101YM0800X
NCLCAS-26183101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health