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MR. STANLEY MICHAEL EUGENE ALLEN LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1023179116

Individual Registrant:
MR. STANLEY MICHAEL EUGENE ALLEN LCSW
Gender: M
Sole Proprietor

Location and contact information for practice:
1770 INDIAN TRAIL RD SUITE 200 NORCROSS, GA 30093-2645 US
Tel: 770-923-9200  Fax: --

Contact information for business:
1499 KAY LN NE  ATLANTA, GA 30306-3111 US
Tel: 404-219-5821  Fax: --

Registration Information:
NPI: 1023179116
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
GACSW000707

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
032860193AGA05




HEALTH CARE JOBS GA - Page 1



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