Provider Demographics
NPI:1598194045
Name:BROYHILL, STEPHANIE (CMHC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BROYHILL
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 WARDS GAP RD # HOUSE1
Mailing Address - Street 2:
Mailing Address - City:CASAR
Mailing Address - State:NC
Mailing Address - Zip Code:28020-7739
Mailing Address - Country:US
Mailing Address - Phone:704-240-1656
Mailing Address - Fax:
Practice Address - Street 1:201 W 2ND AVE STE C
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4091
Practice Address - Country:US
Practice Address - Phone:704-240-1656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12229329-6008101YA0400X
NC10512101YM0800X
UT12229329-6004101YM0800X
NC3514101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health