Provider Demographics
NPI:1609750488
Name:WEBER, STEPHANIE RYAN (LCMHCA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RYAN
Last Name:WEBER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W FRANKLIN ST UNIT 701
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2588
Mailing Address - Country:US
Mailing Address - Phone:843-708-0992
Mailing Address - Fax:
Practice Address - Street 1:508 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5110
Practice Address - Country:US
Practice Address - Phone:910-787-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health