Stephanie Renee Dates, LICSW
Individual provider Active NPI Clinical Social Worker · Talladega, AL
NPI 1831829191 · NPPES record last updated Jun 10, 2022
Key facts
- NPI
- 1831829191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4876C (AL)
- Practice address
- 285 Hindman LN
Talladega, AL 35160-6448 - Phone
- (256) 493-2282
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4876C | AL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mending Hearts Counseling Services of Central Alabama, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4876C | AL | Yes |
Addresses
Primary practice location
285 Hindman LN
Talladega, AL 35160-6448
Mailing address
285 Hindman LN
Talladega, AL 35160-6448
Phone (256) 493-2282
Other providers in Talladega, AL
- Coosa Valley Limb & Brace, LLC
- Colleen Craig-Akinsanya
- Joseph F Daniel
- Sherron C Daniel
- Dennis Frank Dase
- Anne B. Davis
- Ellen C Davis
- Jimmy W. Davis
- Deborah Edwards Dba Discount Optical Depot
- James Lewis Dickinson
All providers in Talladega, AL · Clinical Social Worker in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.