Mark Jude Stanford, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10658 Issued in LA

Practice address

1003 Hugh Wallis Rd S
C-6
Lafayette, LA 70508-2528

Phone

(337) 344-1617

NPI assigned

Apr 7, 2012

Last updated

Apr 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333756800000",
    "number": "1073879649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HOWARD AVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064402",
            "telephone_number": "337-344-1617",
            "fax_number": "337-289-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 HUGH WALLIS RD S",
            "address_2": "C-6",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705082528",
            "telephone_number": "337-344-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "MARK",
        "middle_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-07",
        "last_updated": "2012-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "10658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE #",
            "identifier": "10658",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Staggs, RDN, LDN
• Steven K Staires, MD
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• Sheena L Stakes, LCSW, MSW
• Celenia A Stanford, PA-C
• Dala Stansbury, MBA
• Marie Denise Fuselier Stansbury, LMSW
• Richard Stansbury
• Michael A. Stanton, LCSW
• Kristine Starkovich, CRNA

• Clinical Social Worker in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.