Stacy D. Witherspoon

Behavior Technician · Stone Mountain, GA

Individual Active NPI

NPI number 1417575507

Practice location

2300 W Park Pl
Stone Mountain, GA 30087-6713
Phone
(678) 330-1400

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NPI record

NPI
1417575507
Entity type
Individual (Type 1)
Enumeration date
July 6, 2020
Last updated
November 27, 2023
Certified
July 6, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Technician Primary 106S00000X — —

Mailing address

2300 W Park Pl Ste 125
Stone Mountain, GA 30087-3561
Phone
(678) 330-1400

Other practice locations (1)

  • 736 Deshon Creek Dr, Lithonia, GA 30058-2933 · (678) 891-8073

About Stacy Witherspoon

Stacy D. Witherspoon is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Technician (code 106S00000X). The practice location is 2300 W Park Pl, Stone Mountain, GA 30087-6713. The NPI number 1417575507 was assigned on July 6, 2020 and the record was last updated on November 27, 2023.

Frequently asked questions

What is the NPI number of Stacy D. Witherspoon?

The NPI number is 1417575507.

What is the phone number of Stacy Witherspoon?

The phone number listed for the practice location is (678) 330-1400.

Where is Stacy Witherspoon located?

2300 W Park Pl, Stone Mountain, GA 30087-6713.

What is the taxonomy code for Stacy Witherspoon?

The primary taxonomy code is 106S00000X – Behavior Technician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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