Provider Demographics
NPI:1912916172
Name:MASINTER, STANLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:MASINTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7936 WRENWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7701
Mailing Address - Country:US
Mailing Address - Phone:225-927-0252
Mailing Address - Fax:225-926-2101
Practice Address - Street 1:7936 WRENWOOD BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7701
Practice Address - Country:US
Practice Address - Phone:225-927-0252
Practice Address - Fax:225-926-2101
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B455Medicare ID - Type Unspecified