Active NPI
Stacey Moran, CAC-AD
- Addiction (Substance Use Disorder) Counselor
- Elkton, MD
National Provider Identifier
1912774555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- AC2912
- Practice address
- 212 Blue Ball Ave
Elkton, MD 21921-5222 - Phone
- (443) 993-8227
- NPI assigned
- Dec 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AC2912 | MD | Primary |
Addresses
Primary practice location
212 Blue Ball Ave
Elkton, MD 21921-5222
Mailing address
3839 Memory LN Apt a
Abingdon, MD 21009-2949
Phone (443) 643-5828
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC2912 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1912774555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3839 MEMORY LN APT A",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210092949",
"telephone_number": "443-643-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 BLUE BALL AVE",
"city": "ELKTON",
"state": "MD",
"postal_code": "219215222",
"telephone_number": "443-993-8227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "STACEY",
"credential": "CAC-AD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "AC2912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkton, MD
- Steve Montalvo, DPT
- Robert Anthony Monteleone, M.D.
- Jaid-Alexandra Montgomery, LMSW
- Ronald Tyler Montgomery, LGPC
- Andrew Thomas Moore, MSN, APRN, PMHNP-BC
- Malcolm K Moses-Hampton, MD
- Toccara Monique Mosley, CRNP
- Shouleh Motamedi, DDS
- Mother to Mother:Birth and Postpartum Support Services, Inc.
- Mountain Spring Vascular
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.