Provider Demographics
NPI:1083944110
Name:STURDY, MARJORIE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:ELIZABETH
Last Name:STURDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 H ST STE C-1
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1221
Mailing Address - Country:US
Mailing Address - Phone:209-554-2554
Mailing Address - Fax:
Practice Address - Street 1:1801 H ST STE C-1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354
Practice Address - Country:US
Practice Address - Phone:209-247-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical