Stacie Peterson, Lcmhc, LPC, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STACIE PETERSON, LCMHC, LPC, LLC

Practice address

242 S Bragg Blvd
Spring Lake, NC 28390-3929

Phone

(919) 346-3733

NPI assigned

Nov 3, 2022

Organization subpart

No

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

Authorized official

Name

Stacie PetersonNPI 1902299324

Title

Counselor

Phone

(919) 346-3733

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacie Peterson, LPCA

  • Professional Counselor
  • Willow Spring, NC
  • NPI 1902299324
  NPD Authorized official

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1891402384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 ELWOOD DR",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 S BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903929",
            "telephone_number": "919-346-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACIE PETERSON, LCMHC, LPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "919-346-3733"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCMHC LICENSE NUMBER",
            "identifier": "11188",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominic McRae Snow
• Justine Sommer
• Jaynia Shanise Spraglin
• Spring Lake Counseling Center PLLC
• Spring Lake Counseling Inc.
• Ny'Asia Maniya Stamps
• Gao Tang Stanley
• Skyley A Stencil
• Melissa Steury
• Swanzetta Johnson Stevenson

• Community/Behavioral Health Agency in Spring Lake, NC
• Providers in Spring Lake, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.