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General NPI Number Information
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NPI Number | 1619091113
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Entity Type | Individual
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Provider Name | RICHARD WILLIAM STANZIONE L.C.S.W.-C
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 318 N POTOMAC ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-3888
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Country | US
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Telephone | 301-797-3004
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Fax | 301-797-3438
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Provider Business Mailing Address
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Address Line | 4487 TULIP TREE LN
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City | MIDDLETOWN
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State | MD
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Zip | 21769-7612
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Country | US
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Telephone | 301-293-6999
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Fax | 301-797-3438
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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 | 04229
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License Number State | MD
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