Provider Demographics
NPI:1619091113
Name:STANZIONE, RICHARD WILLIAM (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:STANZIONE
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4487 TULIP TREE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7612
Mailing Address - Country:US
Mailing Address - Phone:301-293-6999
Mailing Address - Fax:301-797-3438
Practice Address - Street 1:318 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3888
Practice Address - Country:US
Practice Address - Phone:301-797-3004
Practice Address - Fax:301-797-3438
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical