Individual provider Active NPI

Michael Stonebraker, CSAC, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Roswell, GA
National Provider Identifier
1760710180
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
028-556-D Issued in GA
Practice address
5110 Old Ellis PT
Roswell, GA 30076-3863
Phone
(770) 751-8383
Fax
(770) 751-7282
NPI assigned
Nov 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 028-556-D GA Primary

Addresses

Primary practice location

5110 Old Ellis PT
Roswell, GA 30076-3863

Mailing address

5110 Old Ellis PT
Roswell, GA 30076-3863
Phone (770) 751-8383

Other practice location 1

13944 Lynmar Blvd
Tampa, FL 33626-3123
Phone (813) 575-5075

Other practice location 2

103 Towerview Ct
Cary, NC 27513-3187
Phone (919) 679-7577

Other practice location 3

920 Blairhill Rd Ste B-103
Charlotte, NC 28217-1565
Phone (704) 679-9600

Other practice location 4

1139 Senoia Rd
Tyrone, GA 30290-1625
Phone (770) 751-6334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
028-556-DGAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stonebraker'S Inc. Addiction (Substance Use Disorder) Past Accepting new patients
Stonebrakers Florida Inc Addiction (Substance Use Disorder) PastSince Dec 6, 2022 Accepting new patients
Stonebraker'S Inc. Addiction (Substance Use Disorder) Past Accepting new patients
Stonebraker'S Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1760710180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 OLD ELLIS PT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763863",
            "telephone_number": "770-751-8383",
            "fax_number": "770-751-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 OLD ELLIS PT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763863",
            "telephone_number": "770-751-8383",
            "fax_number": "770-751-7282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13944 Lynmar Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336263123",
            "country_code": "US",
            "telephone_number": "813-575-5075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Towerview Ct",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275133187",
            "country_code": "US",
            "telephone_number": "919-679-7577",
            "fax_number": "919-378-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Blairhill Rd Ste B-103",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282171565",
            "country_code": "US",
            "telephone_number": "704-679-9600",
            "fax_number": "704-679-9602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1139 Senoia Rd",
            "address_purpose": "LOCATION",
            "city": "Tyrone",
            "state": "GA",
            "postal_code": "302901625",
            "country_code": "US",
            "telephone_number": "770-751-6334",
            "fax_number": "770-751-3746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONEBRAKER",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CSAC, CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "028-556-D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.