Stallworth Community Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STALLWORTH COMMUNITY SERVICES INC

Practice address

304 26TH Avenue East
Bradenton, FL 34208

Phone

(941) 536-4449

Fax

(941) 355-8699

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Janell Latrice Stallworth, MA

Title

President Executive Director

Phone

(941) 536-4449

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Successful Development Inc Former legal business name

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1265690366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57",
            "city": "TALLEVAST",
            "state": "FL",
            "postal_code": "34270",
            "telephone_number": "941-536-4449",
            "fax_number": "941-355-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 26TH AVENUE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34208",
            "telephone_number": "941-536-4449",
            "fax_number": "941-355-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STALLWORTH COMMUNITY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "LATRICE",
        "authorized_official_title_or_position": "PRESIDENT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "941-536-4449",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690209096",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Successful Development Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Renee St Laurent, ARNP
• David Alan Stacho, LMHC
• Stacy Greeter, MD, PLLC
• Stanislav Stadnikov
• Mary E Stahr, LCSW
• Sarah Ellen Stanczyk
• Matthew Alan Stanek, PHARM D
• Caitlin Alexandra Stange, RBT
• Margot Stanhope, LMHC
• Anya Stankiewicz

• Community/Behavioral Health Agency in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.