Provider Demographics
NPI:1457172488
Name:STALLING, CAROLYN JUNE (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JUNE
Last Name:STALLING
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:JUNE
Other - Last Name:STALLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:1308 DELIA CHAPA
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5463
Mailing Address - Country:US
Mailing Address - Phone:844-428-4872
Mailing Address - Fax:
Practice Address - Street 1:6633 E HWY 290 STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1158
Practice Address - Country:US
Practice Address - Phone:844-428-4872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker