Individual provider · Type 1 NPI
Stacy Natasha Wilson, PSY.D., LCAS, MAC
Addiction (Substance Use Disorder) Counselor · Winton, NC
NPI number
1992261085
Active
Practice location
145 Parker Fishery Rd
Winton, NC 27986-9763
Mailing address
1014 Island Park Cir
Suffolk, VA 23435-3275
Other practice locations
- 1014 Island Park Cir, Suffolk, VA 23435-3275 · (646) 244-9493
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist | 103T00000X | 4371 (NC) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LCAS-3290 (NC) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1992261085
Stacy Natasha Wilson, PSY.D., LCAS, MAC's National Provider Identifier is 1992261085, issued on Feb 14, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Winton, NC. The record was last updated on Feb 14, 2019.