Provider Demographics
NPI:1659507655
Name:STAHL, PATRICIA LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEE
Last Name:STAHL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CARLISLE ST
Mailing Address - Street 2:#108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1358
Mailing Address - Country:US
Mailing Address - Phone:214-724-6696
Mailing Address - Fax:214-939-5214
Practice Address - Street 1:3100 CARLISLE ST
Practice Address - Street 2:#108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1358
Practice Address - Country:US
Practice Address - Phone:214-724-6696
Practice Address - Fax:214-939-5214
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0005631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical