Provider Demographics
NPI:1144917170
Name:STANLEY PSYCHOLOGY PLLC
Entity type:Organization
Organization Name:STANLEY PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-592-0750
Mailing Address - Street 1:4102 NICKLAUS AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5863
Mailing Address - Country:US
Mailing Address - Phone:832-858-3133
Mailing Address - Fax:
Practice Address - Street 1:108 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-1602
Practice Address - Country:US
Practice Address - Phone:817-592-0750
Practice Address - Fax:817-259-2491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty