Provider Demographics
NPI:1952557175
Name:STIRK, CHARLES RODNEY (LPC, LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:RODNEY
Last Name:STIRK
Suffix:
Gender:M
Credentials:LPC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 ACADEMY
Mailing Address - Street 2:
Mailing Address - City:NEW BRUANFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5610
Mailing Address - Country:US
Mailing Address - Phone:830-708-0731
Mailing Address - Fax:
Practice Address - Street 1:248 ACADEMY
Practice Address - Street 2:
Practice Address - City:NEW BRUANFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5610
Practice Address - Country:US
Practice Address - Phone:830-708-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5265101YP2500X
TX133171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional