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General NPI Number Information
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NPI Number | 1548732829
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Entity Type | Individual
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Provider Name | STACY CHAMBERLAIN MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 145 S DURBIN ST STE 307
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City | CASPER
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State | WY
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Zip | 82601-2567
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Country | US
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Telephone | 307-267-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 12 N COYOTE RD
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City | ROLLING HILLS
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State | WY
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Zip | 82637-9635
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Country | US
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Telephone | 307-267-2150
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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 | 1318
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License Number State | WY
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