Provider Demographics
NPI:1881188126
Name:TUNSTALL, STEPHEN LEONARD (LSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LEONARD
Last Name:TUNSTALL
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1886 RITCHIE RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1859
Mailing Address - Country:US
Mailing Address - Phone:330-607-7157
Mailing Address - Fax:
Practice Address - Street 1:5860 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-1752
Practice Address - Country:US
Practice Address - Phone:330-607-7157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker