Stacy Natasha Wilson, PSYD, LCAS, MAC is a
Counselor - Addiction (substance Use Disorder) based in Winton, North Carolina. Stacy Natasha Wilson is licensed to practice in North Carolina (license number LCAS-3290) and her current practice location is
145 Parker Fishery Rd, Winton, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(252) 358-5200.
NPI number for Stacy Natasha Wilson is 1992261085 and her current mailing address is 1014 Island Park Cir, Suffolk, Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992261085.
Healthcare Provider's Profile
| Full Name | Stacy Natasha Wilson |
|---|
| Gender | Female |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 145 Parker Fishery Rd, Winton, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1992261085
- Provider Enumeration Date: 02/14/2019
- Last Update Date: 02/14/2019
Medical Identifiers
Medical identifiers for Stacy Natasha Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992261085 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 4371 (North Carolina) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAS-3290 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Natasha Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Stacy Natasha Wilson, PSYD, LCAS, MAC
1014 Island Park Cir,
Suffolk, VA 23435-3275
Ph: () - | Stacy Natasha Wilson, PSYD, LCAS, MAC
145 Parker Fishery Rd,
Winton, NC 27986-9763
Ph: (252) 358-5200 |
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