Individual
BRENDA ANITA STALLINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CASAC
Contact information
Practice address
8264 164TH ST, JAMAICA, NY 11432-1121
(718) 883-4205
Mailing address
17240 133RD AVE APT 1E, JAMAICA, NY 11434-3925
(347) 869-7918
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
9331
NY
1041C0700X
Clinical Social Worker
Primary
074027
NY
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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