Provider Demographics
NPI:1508895285
Name:STALLINGS, SHEILA CLARK (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:CLARK
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 GOLF HOUSE ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377
Mailing Address - Country:US
Mailing Address - Phone:336-689-8901
Mailing Address - Fax:
Practice Address - Street 1:709 EAST MARKET STREET SUITE 100 B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-378-0109
Practice Address - Fax:336-378-0180
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103TA0400X, 101YM0800X
NC200200610101YM0800X, 103TP0016X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913117Medicaid
NC080188607OtherRR MEDICARE
NC1212660021OtherDME
NC1212660030Medicare NSC
NC8913117Medicaid
H32617Medicare UPIN
NC2007528Medicare PIN