Stacey Colebrook, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN157462 Issued in GA

Practice address

1919 John Wesley Ave
College Park, GA 30337-3605

Phone

(404) 762-9190

Fax

(404) 762-9101

NPI assigned

Dec 4, 2007

Last updated

Dec 4, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/odysseycounseling/r4/

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.

• Odyssey Family Counseling Center Corporation

  • Mental Health Counselor
  • College Park, GA
  • NPI 1689604605
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1912189754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3578 S FULTON AVE",
            "city": "HAPEVILLE",
            "state": "GA",
            "postal_code": "303541756",
            "telephone_number": "404-768-1156",
            "fax_number": "404-768-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 JOHN WESLEY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373605",
            "telephone_number": "404-762-9190",
            "fax_number": "404-762-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEBROOK",
        "first_name": "STACEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN157462",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "RN157462",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "GA",
            "license": "RN157462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CJR Special Transportation LLC
• Victoria Clark, RBT
• Clayton Pharma LLC (NuHope Pharmacy)
• Coastal Community Senior Living Services LLC (Hiyh)
• Nyeshia Sherelle Cohill
• College Park Dialysis, LLC (Fresenius Medical Care College Park)
• College Park Regional Health Center
• Yasmin Collier-Kenney, RN
• Community Behavioral Center LLC (111 dui school)
• Community Counseling & Resource Center Inc.

• Registered Nurse in College Park, GA
• Providers in College Park, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.