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Individual
MARCUS ALLEN STALLWORTH
Active
Individual
MARCUS ALLEN STALLWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
1025
CT
Other
Enumeration date
12/18/2014
Last updated
04/15/2015
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