Provider Demographics
NPI:1184034662
Name:STANY, MARTHA A (LCSW, MSW, ADS)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:STANY
Suffix:
Gender:F
Credentials:LCSW, MSW, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 JACKSON KELLER RD STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2723
Mailing Address - Country:US
Mailing Address - Phone:210-201-5585
Mailing Address - Fax:
Practice Address - Street 1:117 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78203
Practice Address - Country:US
Practice Address - Phone:210-201-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490182591041C0700X
COCSW.099275231041C0700X
TX693141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical