IndividualActive
Stacy Witherspoon
NPI 1417575507 · Behavior Technician · Stone Mountain, GA
Provider details
- NPI number
- 1417575507
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2300 W Park Pl
Stone Mountain, GA 30087-6713
Phone: (678) 330-1400
Street-level locationGet directions
Mailing address
2300 W Park Pl Ste 125
Stone Mountain, GA 30087-3561
Additional practice locations (1)
- 736 Deshon Creek DrLithonia, GA 30058-2933Phone: (678) 891-8073
Registry dates
- Enumerated
- 2020-07-06
- Last updated
- 2023-11-27
- Certified
- 2020-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.