Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey Longoria, PMHNP-C

Individual provider Nurse Practitioner · NPI 1497149264

Stacey Longoria, PMHNP-C is a Nurse Practitioner in Huntersville, North Carolina. Qualified in 2024, 2 years ago. Practices with Boulder Care Provider Group PA, a 109-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

9525 Birkdale Crossing Dr Ste 300
Huntersville, NC 28078-8459
Phone: (704) 317-2930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 612 Mocksville Ave, Salisbury, NC 28144-2732 — (704) 210-5061

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5022115 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence 5022115 (NC)

Record details

NPI number1497149264
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-C
Sole proprietorNo
NPI enumeratedMarch 19, 2015
Last updated in NPPESJune 3, 2026
Certification dateJune 3, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Boulder Care Provider Group Pa — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Huntersville