Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1032 | NC |
Y | 103T00000X | Psychologist | 1032 | NC |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1032 | NC |
N | 103TA0700X | Adult Development & Aging Psychologist | 1032 | NC |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1032 | NC |
N | 103G00000X | Clinical Psychologist | 1032 | NC |
N | 103TC0700X | Clinical Psychologist | 1032 | NC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1032 | NC |
N | 103TF0000X | Family Psychologist | 1032 | NC |
NPI | 1174576540 |
---|---|
Provider Name | Dr. Mark R Stein |
First Address | Cary, NC 27518-8507 |
Second Address | Cary, NC 27518-8507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 29/08/2007 |