| Doctor Name: | MR. STALIN GEORGE |
| NPI Number: | 1013343540 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.C |
| License Number: | 178007775 |
| Business Practice Address: | 1616 E Roosevelt Rd Suite 8 Wheaton, IL - 60187 |
| Business Phone Number: | 6305888042 |
| Business Fax Number: | |
| Mailing Address: | 505 N. Kenilworth Ave, Apartment 9 GLEN ELLYN |
| State: | IL |
| Postal Code: | 60137 |
| Phone Number: | 6305888042 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2013 |
| NPI Last Update Date: | 09/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178007775 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |