Provider Demographics
NPI:1568470847
Name:STALLWORTH, KARLA (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:KARLA
Middle Name:
Last Name:STALLWORTH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MAN MAR DR UNIT 5
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2270
Mailing Address - Country:US
Mailing Address - Phone:508-821-6567
Mailing Address - Fax:508-316-0924
Practice Address - Street 1:60 MAN MAR DR UNIT 5
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2270
Practice Address - Country:US
Practice Address - Phone:508-821-6567
Practice Address - Fax:508-316-0924
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4298101YM0800X
RIMHC00150101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health