Provider Demographics
NPI:1457943359
Name:STOCKS, DYLAN (CADC-I, MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:STOCKS
Suffix:
Gender:M
Credentials:CADC-I, MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359-0008
Mailing Address - Country:US
Mailing Address - Phone:910-522-0421
Mailing Address - Fax:
Practice Address - Street 1:3460 CAPUANO RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3478
Practice Address - Country:US
Practice Address - Phone:910-522-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0144511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical