Davis, Stacy Marshall

Davis, Stacy Marshall is an individual health care provider with primary practice located at 250 Dewey Ave , Spartanburg SC 29303-3009. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Davis, Stacy Marshall can be contacted via phone (864) 585-0366.

Contact Information

Primary practice address
250 Dewey Ave Spartanburg SC 29303-3009
Phone: (864) 585-0366
Fax: (864) 583-3136
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X 7475 South Carolina

Profile Details

NPI number 1366779902
LBN Legal business name Davis, Stacy Marshall
Credentials MACC, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2009
Last updated Jul 1st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366779902 NPPES
South Carolina MEDICAID 121328

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