Provider Demographics
NPI:1134426968
Name:FURNESS-KRAFT, STEPHANIE L (LCSW)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:L
Last Name:FURNESS-KRAFT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CROOKED CREEK RUN
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-6422
Mailing Address - Country:US
Mailing Address - Phone:984-833-8374
Mailing Address - Fax:
Practice Address - Street 1:130 CROOKED CREEK RUN
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-6422
Practice Address - Country:US
Practice Address - Phone:919-583-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0042941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW004294OtherSTATE CLINICAL SOCIAL WORK LICENSE NUMBER