Provider Demographics
NPI:1457472367
Name:STANCZAK, CAROLINE B
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:B
Last Name:STANCZAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6929 W 130TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7895
Mailing Address - Country:US
Mailing Address - Phone:440-842-6867
Mailing Address - Fax:440-842-8914
Practice Address - Street 1:6929 W 130TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7895
Practice Address - Country:US
Practice Address - Phone:440-842-6867
Practice Address - Fax:440-842-8914
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor