Provider Demographics
NPI:1295379899
Name:STANCHAK, MALGORZATA (MS, NCC, LCMHC)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:STANCHAK
Suffix:
Gender:F
Credentials:MS, NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 OCEAN HWY S
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-1437
Mailing Address - Country:US
Mailing Address - Phone:252-573-1189
Mailing Address - Fax:
Practice Address - Street 1:905 HALSTEAD BLVD STE 14
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6815
Practice Address - Country:US
Practice Address - Phone:252-573-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional