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Individual
STACY L MANDZIJ
Active
Individual
STACY L MANDZIJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L8570
OR
1041C0700X
Clinical Social Worker
Primary
L8570
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500734958
—
OR
Enumeration date
09/19/2017
Last updated
03/13/2026
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