Provider Demographics
NPI:1497799696
Name:STANLEY, FRANK G (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:G
Last Name:STANLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 BOWDEN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6149
Mailing Address - Country:US
Mailing Address - Phone:904-448-0079
Mailing Address - Fax:904-636-9661
Practice Address - Street 1:6545 BOWDEN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6149
Practice Address - Country:US
Practice Address - Phone:904-448-0079
Practice Address - Fax:904-636-9661
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003949103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73192Medicare ID - Type Unspecified