STACY JAYNES ANDERSON (NPI# 1528029089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528029089 |
| Entity Type | Individual |
| Full Name | STACY JAYNES ANDERSON |
| Credential | M.ED., LPC |
| Practice Address |
6130 Prestley Mill Rd Suite A Douglasville GA 30134-2288 |
| Practice Telephone | 7709499675 |
| Practice Fax Number | 7709499676 |
| Mailing Telephone | 7709499675 |
| Mailing Fax Number | 7709499676 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC004243 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063068740 | Stacy Renee Anderson | Technician | 1510 Talon Dr, Cameron, MO 64429-2095 | 2019-08-17 |
| 1366646713 | Stacy Lynette Anderson | Social Worker | 1501 N Meridian Ave, Wichita, KS 67203-1942 | 2007-06-11 |
| 1306457031 | Stacy Anne Anderson | Behavior Technician | 6910 S Highland Dr, Cottonwood Heights, UT 84121-3060 | 2020-08-15 |
| 1144846064 | Stacy Ann Anderson | Registered Nurse | 3230 Waring Ct Ste A, Oceanside, CA 92056-4509 | 2020-06-17 |
| 1942824701 | Stacy Lynn Anderson | Pharmacist | 305 S State St, Aberdeen, SD 57401-4527 | 2020-06-07 |
| 1386094134 | Stacy Anderson | Case Manager/Care Coordinator | 4700 Wichers Dr Ste 206, Marrero, LA 70072-3054 | 2016-06-13 |
| 1376949842 | Stacy Diane Anderson | Counselor | 2601 Pasadena Blvd, Pasadena, TX 77502-3265 | 2014-11-11 |
| 1619210648 | Stacy Lee Anderson | Internal Medicine | 1275 York Ave, New York, NY 10065-6007 | 2013-03-28 |
| 1093020653 | Stacy Jennifer Anderson | Counselor | 4368 Lincoln Ave, Oakland, CA 94602-2529 | 2010-08-07 |
| 1710114038 | Stacy Anderson | Pharmacist | 1401 N 1st St, Grand Junction, CO 81501-2139 | 2009-06-12 |
| Street Address |
6130 PRESTLEY MILL RD SUITE A |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831150028 | Samuel Delafield Haskell | Psychologist | 6130 Prestley Mill Rd, Suite A, Douglasville, GA 30134-2288 | 2006-03-29 |
| 1841431277 | Kristy Strickland Moore | Nurse Practitioner | 6130 Prestley Mill Rd, Suite B, Douglasville, GA 30134-2288 | 2009-03-15 |
| 1629039813 | Dennis L Herendeen | Psychologist | 6130 Prestley Mill Rd, Suite A, Douglasville, GA 30134-2288 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462864 | Angela Smith | Counselor | 3239 Blackley Old Rd, Douglasville, GA 30135-8119 | 2020-09-21 |
| 1790390862 | Quinsana Beaty | Counselor | 8319 Office Park Dr Ste A, Douglasville, GA 30134-6936 | 2020-09-15 |
| 1164030946 | Ashley Hackett | Counselor | 6876 Laurel Ridge Ct, Douglasville, GA 30135-1619 | 2020-07-17 |
| 1164048302 | Denese Natalee Bell-martin | Counselor | 5369 Legacy Trl, Douglasville, GA 30135-5865 | 2020-06-23 |
| 1770104234 | Teresa Kimbrough | Counselor | 3690 Lindsy Brooke Ct, Douglasville, GA 30135-3082 | 2020-05-06 |
| 1255952412 | Lajuan Spivey | Counselor | 8337 Park Drive, Douglasville, GA 30129 | 2020-04-29 |
| 1144864190 | Felicia M Williams | Counselor | 3080 Highland Hill Pkwy, Douglasville, GA 30135-8636 | 2019-11-03 |
| 1407335797 | Carla Bolton | Counselor | 4911 Crinklepoint Ct, Douglasville, GA 30134-3981 | 2018-08-08 |
| 1407333008 | Sabrina K Callaway | Counselor | 4462 Sunflower Dr, Douglasville, GA 30135-4226 | 2018-07-26 |
| 1245751361 | Debra A Kemp | Counselor | 290 Paradise Dr, Douglasville, GA 30134-5283 | 2017-06-28 |
| Find all providers in DOUGLASVILLE | ||||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
Please comment or provide details below to improve the information on STACY JAYNES ANDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.