Provider Demographics
NPI:1295987162
Name:COE, STACY B (MDIV, MSW, LCSW)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:B
Last Name:COE
Suffix:
Gender:F
Credentials:MDIV, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-0384
Mailing Address - Country:US
Mailing Address - Phone:336-497-1603
Mailing Address - Fax:364-973-1603
Practice Address - Street 1:4225 BRENTONSHIRE LN
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9409
Practice Address - Country:US
Practice Address - Phone:336-779-4760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0069381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical