Stacey Longoria, PMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5022115 Issued in NC

Practice address

9525 Birkdale Crossing Dr Ste 300
Huntersville, NC 28078-8459

Phone

(704) 317-2930

NPI assigned

Mar 19, 2015

Sex

Female

Sole proprietor

No

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

Enrolled in NC, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.staceylongoria@146232.advancedmd-direct.com

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

• Boulder Care Provider Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  NC, OH

  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment
• Integrative Wellness Solutions, PLLC

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1497149264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 BIRKDALE CROSSING DR STE 300",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788459",
            "telephone_number": "704-317-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 BIRKDALE CROSSING DR STE 300",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788459",
            "telephone_number": "704-317-2930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Mocksville Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442732",
            "country_code": "US",
            "telephone_number": "704-210-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "STACEY",
        "credential": "PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5022115",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5022115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kameron Logan, DC
• Christine Ann Logue
• Christine Trinidad Lomboy, MD
• Londry Modlin Tucker & Zimmer II DDS PLLC
• Nicole Jones Long, LCSW
• Alexander Lopez, MS, LPA, HSP-PA
• Jennifer Lopez, FNP
• Sophia Lopez
• Love and Acceptance LLC
• Karen Lowdermilk

• Psychiatric/Mental Health Nurse Practitioner in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.