Provider Demographics
NPI:1982299129
Name:CURRIE, STACIE
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:CURRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 BROOKSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-6532
Mailing Address - Country:US
Mailing Address - Phone:229-224-0545
Mailing Address - Fax:
Practice Address - Street 1:3529 BROOKSTONE WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-6532
Practice Address - Country:US
Practice Address - Phone:229-224-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health