Provider Demographics
NPI:1932857323
Name:STANLEY, CHANTAY
Entity Type:Individual
Prefix:
First Name:CHANTAY
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 ASHBERRY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-6609
Mailing Address - Country:US
Mailing Address - Phone:443-462-9193
Mailing Address - Fax:
Practice Address - Street 1:285 ASHBERRY LN
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-6609
Practice Address - Country:US
Practice Address - Phone:443-462-9193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical