Provider Demographics
NPI:1902972946
Name:STALLINGS, AMBER RENEE (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:RENEE
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3491 EVANS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4534
Mailing Address - Country:US
Mailing Address - Phone:252-814-4646
Mailing Address - Fax:
Practice Address - Street 1:3491 EVANS ST
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4534
Practice Address - Country:US
Practice Address - Phone:252-814-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5043101YP2500X
NC927101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6111778Medicaid
NC1413GOtherBCBS