Provider Demographics
NPI:1023393501
Name:CLEVELAND, STACY ARNETT (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:ARNETT
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MARTHA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1412
Mailing Address - Country:US
Mailing Address - Phone:850-748-0721
Mailing Address - Fax:
Practice Address - Street 1:4994 LOWER ROSWELL RD STE 10
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4332
Practice Address - Country:US
Practice Address - Phone:770-565-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst