Provider Demographics
NPI:1982691275
Name:STANLEY, DONNA (LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2913
Mailing Address - Country:US
Mailing Address - Phone:919-990-1011
Mailing Address - Fax:919-933-3607
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:900B
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-990-1011
Practice Address - Fax:919-933-3607
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-01
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2115023OtherMAMSI
NCC7980OtherMEDCOST
NC134X0OtherBCBSNC
NC310637OtherMHN
NC6002734Medicaid
NC6002734Medicaid