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General NPI Number Information
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NPI Number | 1447929039
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Entity Type | Individual
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Provider Name | SHAUN E STANLEY LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 300 HIGHPOINT AVE
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City | PORTSMOUTH
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State | RI
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Zip | 02871-1445
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Country | US
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Telephone | 401-213-9597
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Fax |
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Provider Business Mailing Address
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Address Line | 30 FAIRVIEW AVE
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City | MIDDLETOWN
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State | RI
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Zip | 02842-4950
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Country | US
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Telephone | 401-924-1054
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Fax |
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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 | ISW03967
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License Number State | RI
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