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General NPI Number Information
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NPI Number | 1629246384
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Entity Type | Individual
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Provider Name | LYNNE MARIE STANLEY MSW, LCSW, ACSW, CTT
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Gender | Female
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 7204 ALGOA BAY LN
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City | WILMINGTON
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State | NC
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Zip | 28409-0500
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Country | US
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Telephone | 304-830-2573
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Fax |
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Provider Business Mailing Address
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Address Line | 7204 ALGOA BAY LN
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City | WILMINGTON
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State | NC
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Zip | 28409-0500
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Country | US
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Telephone | 304-830-2573
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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 | C015469
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License Number State | NC
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