Stacey Phillips

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN327767 Issued in GA

Practice address

100 Governors Trce Ste 101
Peachtree City, GA 30269-4853

Phone

(770) 268-2520

NPI assigned

Dec 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1396340261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "866-610-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GOVERNORS TRCE STE 101",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694853",
            "telephone_number": "770-268-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN327767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kristine Petersen, NP
• Takana Petty
• Phalanx Med Georgia, LLC
• Pharmacy Place LLC
• Pharmacy Place LLC
• Emson Philogene
• Lu Phoun
• Physiotherapy Associates Inc
• Piedmont Medical Care Corporation
• Ashley Renee Pilato, M.S., BCBA

• Adult Psychiatric/Mental Health Registered Nurse in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.