Individual
MRS. STACY RENEE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3950 COBB PKWY NW STE 501, ACWORTH, GA 30101-9529
(404) 536-8299
Mailing address
593 MOUNT GERIZIM RD SE, MABLETON, GA 30126-6406
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/11/2025
Last updated
11/11/2025
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