Provider Demographics
NPI:1588958573
Name:ROMITO, STEPHANIE KAY (MSC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAY
Last Name:ROMITO
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18611 VINEYARD POINT LANE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7991
Mailing Address - Country:US
Mailing Address - Phone:704-562-3174
Mailing Address - Fax:
Practice Address - Street 1:845 CHURCH STREET NORTH
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4375
Practice Address - Country:US
Practice Address - Phone:704-262-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor