Provider Demographics
NPI:1356872808
Name:GREER, STACEY SMITH (LCSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:SMITH
Last Name:GREER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2199 PHILLIPSBURG RD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:GA
Mailing Address - Zip Code:39841-2009
Mailing Address - Country:US
Mailing Address - Phone:318-302-1053
Mailing Address - Fax:
Practice Address - Street 1:55 RE JENNINGS AVE SE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813-8722
Practice Address - Country:US
Practice Address - Phone:229-758-5012
Practice Address - Fax:229-724-2050
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0060181041C0700X
LA111761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical