Provider Demographics
NPI:1225213739
Name:STALLINGS, GEORGE ELLKEN (LCPC)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ELLKEN
Last Name:STALLINGS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CLOVER VALLEY WAY APT M
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-2162
Mailing Address - Country:US
Mailing Address - Phone:410-262-8974
Mailing Address - Fax:410-671-6692
Practice Address - Street 1:1230 S CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4239
Practice Address - Country:US
Practice Address - Phone:443-524-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional