1. Home
  2. Directory
  3. Georgia
  4. Acworth
  5. Counselor
  6. NPI Profile

MRS. STACY RENEE BLACK
NPI 1063382299
Counselor - Mental Health in Acworth, GA

Active since November 11, 2025
3950 COBB PKWY NW STE 501, ACWORTH, GA 30101(404) 536-8299 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Stacy Renee Black NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. STACY RENEE BLACK (NPI 1063382299) is an individual mental health provider in Acworth, Georgia and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1063382299
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. STACY RENEE BLACK
Location Address3950 COBB PKWY NW STE 501Acworth, GA 30101-9529
Mailing Address593 Mount Gerizim Rd SeMableton, GA 30126-6406
Phone(404) 536-8299
Sole ProprietorYes
Enumeration DateNovember 11, 2025
NPPES CertifiedNovember 11, 2025
✔ NPI 1063382299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3950 COBB PKWY NW STE 501, Acworth, GA 30101
Open in Google Maps ↗

Other Names 1

Other Name (5)Stacy Pettway

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIA IMAN DEVAUGHN
Counselor (Mental Health)
3950 COBB PKWY NW STE 501
ACWORTH, GA 30101
Cobb County (404) 536-8299
ANTHONY JEROME VICKERS M.ED, NCC, ST
Counselor (Mental Health)
3950 COBB PKWY NW STE 501
ACWORTH, GA 30101
Cobb County (770) 616-1706
AMELIA SIMPSON-MORALES
Marriage & Family Therapist
3950 COBB PKWY NW STE 501
ACWORTH, GA 30101
Cobb County (404) 536-8299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Black's NPI number?

The NPI number for Stacy Black is 1063382299. It was assigned to this individual provider in the NPPES registry on November 11, 2025. The provider is also known as Stacy Pettway.

Where is Stacy Black located?

Stacy Black practices at 3950 Cobb Pkwy NW Ste 501, Acworth, GA 30101. The listed phone number is (404) 536-8299.

What is Stacy Black's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Stacy Black was last updated on November 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.