Stephanie Leeanne Phelps

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

12354A Issued in NC

Practice address

1776 Heritage Dr. Ste 204
Wake Forest, NC 27587-3977

Phone

(919) 971-8744

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Forsyth Psychiatric Associates, PLLC

  • Psychiatry Physician
  • Clemmons, NC
  • NPI 1326575994
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1013659614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 QUAIL RIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041320",
            "telephone_number": "910-303-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 HERITAGE DR. STE 204",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873977",
            "telephone_number": "919-971-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "STEPHANIE",
        "middle_name": "LEEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12354A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Louise Petersen, LCSW
• Julie Ann Peterson, M.A.,LPC
• Martin Tsvetanov Petkov
• Jeremy Phan, MS
• Shawn P Phelan, D.O.
• Philip D. Burton M.D. PLLC
• Gregory Phillips, DPM
• Margaret Faye Bergin Phillips, MA, CCC-SLP
• Phoenix and Oak Counseling
• Physical Therapy @ Home LLC

• Marriage & Family Therapist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.