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General NPI Number Information
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NPI Number | 1912124942
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Entity Type | Individual
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Provider Name | SHELLEY ELIZABETH STAHL I MSW,LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 252 KINGS HWY E
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City | HADDONFIELD
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State | NJ
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Zip | 08033-1907
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Country | US
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Telephone | 856-797-1370
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Fax | 856-797-6983
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Provider Business Mailing Address
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Address Line | 24 MASTERS CIR
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City | MARLTON
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State | NJ
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Zip | 08053-3744
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Country | US
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Telephone | 856-983-5487
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Fax | 856-797-6983
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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 | 44SC04675400
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License Number State | NJ
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