Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STEPHAN IDRIS MAMBAZO, MSW, LICSW-PIP, CGRS
Active Sole ProprietorSTEPHAN IDRIS MAMBAZO, MSW, LICSW-PIP, CGRS is a Clinical Social Worker healthcare provider located in MONTGOMERY, Alabama. NPI 1609263052 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · MONTGOMERY, AL
Registration Details
- NPI Number
- 1609263052
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 23, 2015 (11.349622212649 yrs)
- Last Updated
- Mar 1, 2017
- Licenses
-
3796C (AL)SW009851L (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2541 COLLEGE STMONTGOMERY, AL, 361062124Browse AL providers · Browse ZIP 36106
- Phone
- 3342077657
- Primary Specialty
-
Clinical Social Worker
1041C0700X
- Additional Specialty
- Social Worker
Other Clinical Social Worker Providers in MONTGOMERY, AL
| Name | Credential | NPI |
|---|---|---|
| TAMARA JENKINS | MSSW | 1720083371 |
| MARY ROBERTSON | LCSW | 1396790473 |
| DAVID BOND | LCSW | 1932136645 |
| MS. DEBRA FAY MORRIS | — | 1003925231 |
| MISS RANDI CERTRINA HARTSFIELD | LGSW | 1134238298 |
| MR. ARCHIE W. JOHNSON | MSSW | 1407958002 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.