Provider Demographics
NPI:1912124942
Name:STAHL, SHELLEY ELIZABETH I (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:ELIZABETH
Last Name:STAHL
Suffix:I
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MASTERS CIR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3744
Mailing Address - Country:US
Mailing Address - Phone:856-983-5487
Mailing Address - Fax:856-797-6983
Practice Address - Street 1:252 KINGS HWY E
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1907
Practice Address - Country:US
Practice Address - Phone:856-797-1370
Practice Address - Fax:856-797-6983
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046754001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical