Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellen Suratt Stanback, RD, LD, CLC

Individual provider Registered Dietitian · NPI 1780768663

Ellen Suratt Stanback, RD, LD, CLC is a Registered Dietitian in Lithonia, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

2277 Stone Mountain Lithonia Rd
Lithonia, GA 30058-5252
Phone: (770) 484-2600
Fax: (770) 484-3830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence LD001907 (GA)

Record details

NPI number1780768663
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD , LD , CLC
Sole proprietorNo
NPI enumeratedOctober 25, 2006
Last updated in NPPESJuly 8, 2007
Mailing address3177 Kensington Rd, Avondale Estates, GA 30002-1457

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