Healthcare Provider Details

I. General information

NPI: 1326973421
Provider Name (Legal Business Name): BRITTON MARIE STOCKDALE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 STONEBRIDGE BLVD STE B
JACKSON TN
38305-2165
US

IV. Provider business mailing address

77 STONEBRIDGE BLVD STE B
JACKSON TN
38305-2165
US

V. Phone/Fax

Practice location:
  • Phone: 731-207-0560
  • Fax:
Mailing address:
  • Phone: 731-207-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12110
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: