Healthcare Provider Details

I. General information

NPI: 1508895285
Provider Name (Legal Business Name): SHEILA CLARK STALLINGS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 EAST MARKET STREET SUITE 100 B
GREENSBORO NC
27401
US

IV. Provider business mailing address

719 GOLF HOUSE ROAD WEST
WHITSETT NC
27377
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-0109
  • Fax: 336-378-0180
Mailing address:
  • Phone: 336-689-8901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number200200610
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200200610
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number200200610
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: