Provider Demographics
NPI:1114250891
Name:KEARLEY, STEPHEN MARK (SOCIAL WORKER)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MARK
Last Name:KEARLEY
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 JOHNSON RD SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-5847
Mailing Address - Country:US
Mailing Address - Phone:256-650-1726
Mailing Address - Fax:256-650-1780
Practice Address - Street 1:3000 JOHNSON RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-5847
Practice Address - Country:US
Practice Address - Phone:256-650-1701
Practice Address - Fax:256-650-1780
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2719B104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator