Stacy Brooks, LMBT
Individual provider Active NPI Massage Therapist · Clemmons, NC
NPI 1740914472 · NPPES record last updated Jul 9, 2022
Key facts
- NPI
- 1740914472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 20086 (NC)
- Practice address
- 2511 Neudorf Rd Ste E
Clemmons, NC 27012-8922 - Phone
- (336) 618-0664
- NPI assigned
- Jul 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20086 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | 20086 | NC | Yes |
Addresses
Primary practice location
2511 Neudorf Rd Ste E
Clemmons, NC 27012-8922
Mailing address
3718 Cora Dr
Winston Salem, NC 27127-4906
Phone (336) 618-0664
Other providers in Clemmons, NC
- Madeline Gautreaux Brence
- Rachel Hannah Bretz
- Brianna Alexis Brigman
- Jessica Rena Brinkley-McNair
- Wendy Dawn Broadstreet
- Brookstone of Clemmons, LLC
- Melanie Aydt Brost
- Mekella Brown
- Michelle Germaine Brown
- Lindsay Grace Brumfield
All providers in Clemmons, NC · Massage Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.