Provider Demographics
NPI:1376824870
Name:WATKINS-GRIFFITH, STACEY (DMIN)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:
Last Name:WATKINS-GRIFFITH
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-0028
Mailing Address - Country:US
Mailing Address - Phone:828-447-4949
Mailing Address - Fax:
Practice Address - Street 1:200 E MARION ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4610
Practice Address - Country:US
Practice Address - Phone:704-810-4344
Practice Address - Fax:704-810-4345
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral