Individual
CHASSIDY M STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
705 JESSE JEWELL PKWY SE, SUITE 175, GAINESVILLE, GA 30501-3867
(770) 718-9790
(770) 718-5531
Mailing address
4364 SILVER PEAK PKWY, SUWANEE, GA 30024-4016
(770) 362-3268
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003469
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
392701029A
—
GA
05
—
392701029B
—
GA
01
—
GRP7811
MEDICARE B
GA
Enumeration date
08/10/2006
Last updated
02/22/2017
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