Stacey Nickerson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

HC6258 Issued in NC

Practice address

2031 Martin Luther King Jr Dr Ste D
Greensboro, NC 27406-3300

Phone

(336) 588-8268

NPI assigned

Nov 10, 2021

Last updated

Oct 6, 2025By 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 1

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.

• Nancys Family Home Care Agency LLC

  • In Home Supportive Care Agency
  • Greensboro, NC
  • NPI 1790441004
  NPD Authorized official
• Good Family Services Inc

  • Community/Behavioral Health Agency
  • Greensboro, NC
  • NPI 1740089168
  NPD (past)

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1679239974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 LYNHAVEN DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065733",
            "telephone_number": "336-588-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 MARTIN LUTHER KING JR DR STE D",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274063300",
            "telephone_number": "336-588-8268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Elm St Ste 426",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274012675",
            "country_code": "US",
            "telephone_number": "336-383-6498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "HC6258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Smith Nichols, FNP-C
• Ashley Elizabeth Nicholson
• Karen Day Nicholson, FNP
• Yolanda McClam Nicholson, FNP-C
• Lauren Nickerson
• Kristie Jordan Nicks, PHARM.D
• Erin Nicol
• Debra Yvonne Nicoli, LCSW
• Erika Nicolsen, PHARMD
• Mary Niemczura

• Peer Specialist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Peer Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.