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STACEY NICKERSON
NPI 1679239974
Peer Specialist in Greensboro, NC

Active since November 10, 2021
2031 MARTIN LUTHER KING JR DR STE D, GREENSBORO, NC 27406(336) 588-8268 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 6, 2025, Nov 10, 2021 (2 updates tracked since 2021).

About Stacey Nickerson NPPES

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

STACEY NICKERSON (NPI 1679239974) is an individual peer specialist in Greensboro, North Carolina, licensed in North Carolina (HC6258) and active in the NPI registry since November 2021. She maintains a secondary practice location in Greensboro.

NPPES Registry Identity

NPI1679239974
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameSTACEY NICKERSON
Location Address2031 MARTIN LUTHER KING JR DR STE DGreensboro, NC 27406-3300
Mailing Address3716 Lynhaven DrGreensboro, NC 27406-5733 · (336) 588-8268
Phone(336) 588-8268
Sole ProprietorYes
Enumeration DateNovember 10, 2021
Last NPPES UpdateOctober 6, 20252 updates tracked since enumeration
NPPES CertifiedOctober 6, 2025
✔ NPI 1679239974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in NC · HC6258
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
2031 MARTIN LUTHER KING JR DR STE D, Greensboro, NC 27406
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Secondary Practice Location 1

Location 1301 S Elm St Ste 426Greensboro, NC 27401-2675 · Phone (336) 383-6498

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.

GREENLIGHT HOME CARE LLC
In Home Supportive Care
2031 MARTIN LUTHER KING JR DR STE D
GREENSBORO, NC 27406
Guilford County (336) 215-2319
MRS. LANATRA GREEN
Clinical Nurse Specialist (Home Health)
2031 MARTIN LUTHER KING JR DR STE D
GREENSBORO, NC 27406
Guilford County (336) 215-2319
MR. CURTIS BROWNLEE LPCA
Counselor (Professional)
2031 MARTIN LUTHER KING JR DR STE D
GREENSBORO, NC 27406
Guilford County (336) 271-5888

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 Stacey Nickerson's NPI number?

The NPI number for Stacey Nickerson is 1679239974. It was assigned to this individual provider in the NPPES registry on November 10, 2021.

Where is Stacey Nickerson located?

Stacey Nickerson practices at 2031 Martin Luther King Jr Dr Ste D, Greensboro, NC 27406. The listed phone number is (336) 588-8268.

What is Stacey Nickerson's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Stacey Nickerson was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.