MEDICARE: DONNA STANLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C004443	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2115023	OTHER	NC	MAMSI
2	C7980	OTHER	NC	MEDCOST
3	134X0	OTHER	NC	BCBSNC
4	310637	OTHER	NC	MHN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982691275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA STANLEY LCSW

Provider Business Mailing Address
First Line	:	426 RIDGEFIELD RD
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-2913
Country	:	US
Telephone Number	:	919-990-1011
Fax Number	:	919-933-3607

Provider Business Practice Location Address
First Line	:	1829 E FRANKLIN ST
Second Line	:	900B
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-5861
Country	:	US
Telephone Number	:	919-990-1011
Fax Number	:	919-933-3607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2005
Last Update Date	:	03/05/2010

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Directions to “ DONNA STANLEY LCSW” Practice Location

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