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General NPI Number Information
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NPI Number | 1114135357
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Entity Type | Individual
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Provider Name | DAVID JAMES STANFORD MSW, LICSW, LCDP II
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Gender | Male
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 72 3RD ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-2729
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Country | US
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Telephone | 401-276-2723
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Fax | 401-276-2723
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Provider Business Mailing Address
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Address Line | 21 WHITMAN ST
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City | PAWTUCKET
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State | RI
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Zip | 02860-4901
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Country | US
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Telephone | 401-723-4397
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Fax | 401-276-2723
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW01795
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LICSW120720
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License Number State | MA
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