Stacey Hargis Surratt, MT-BC, LCAS, CSI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

23622 Issued in NC

Practice address

10348 Park Rd
Charlotte, NC 28210-8507

Phone

(704) 288-1097

Fax

(704) 817-7421

NPI assigned

Apr 9, 2012

Last updated

Jun 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• The Blanchard Institute

  • Substance Abuse Rehabilitation Facility
  • Cornelius, NC
  • NPI 1265047369
  NPD
• The Blanchard Institute

  • Substance Abuse Rehabilitation Facility
  • Charlotte, NC
  • NPI 1134671399
  NPD (past)

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1356607915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10348 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108507",
            "telephone_number": "704-288-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10348 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108507",
            "telephone_number": "704-288-1097",
            "fax_number": "704-817-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "STACEY",
        "middle_name": "HARGIS",
        "credential": "MT-BC, LCAS, CSI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "23622",
            "primary": true
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NC",
            "license": "10170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgical Specialists of Charlotte, PA-Mercy
• Surgical Specialists of Charlotte, PA-Pineville
• Joshua Benjamin Surowitz, MD
• Joelle Sabaj Surprenant, D.C.
• Marc Jason Surprenant, D.C.
• Cory Surridge, AU.D
• Surviving the Battle, PLLC
• Sadhana Suryadevara
• Uma Suryadevara, MD
• Susan a Hockaday DDS PA

• Addiction (Substance Use Disorder) Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.