Individual provider Active NPI

George Stoupas, PH.D., LCMHC

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1699106906
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16866 Issued in NC
Practice address
2594 Reynolda Rd Ste D
Winston Salem, NC 27106-4601
Phone
(561) 779-9598
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3904 FL
Mental Health Counselor 101YM0800X 12159 FL
Mental Health Counselor 101YM0800X 16866 NC Primary

Addresses

Primary practice location

2594 Reynolda Rd Ste D
Winston Salem, NC 27106-4601

Mailing address

720 Finsbury Rd
Winston Salem, NC 27104-1715
Phone (561) 779-9598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12159FLMDMental Health Counselor
3904FLMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1699106906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 FINSBURY RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041715",
            "telephone_number": "561-779-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2594 REYNOLDA RD STE D",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064601",
            "telephone_number": "561-779-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUPAS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "3904",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "12159",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "16866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.