Provider Demographics
NPI:1861641987
Name:STANLEY, DANIEL LLOYD (LCSW, BCD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LLOYD
Last Name:STANLEY
Suffix:
Gender:M
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 S NETTLETON AVE
Mailing Address - Street 2:#A107
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7551
Mailing Address - Country:US
Mailing Address - Phone:417-439-2174
Mailing Address - Fax:
Practice Address - Street 1:2861 S NETTLETON AVE
Practice Address - Street 2:#A107
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7551
Practice Address - Country:US
Practice Address - Phone:417-439-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070135491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical