Doctor Name: | MR. CHARLES LADD STOLL |
NPI Number: | 1225238660 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW,CASAC |
License Number: | 076977 |
Business Practice Address: | 123 Mearns Ave Highland Falls, NY - 109281009 |
Business Phone Number: | 7187814005 |
Business Fax Number: | 8459770244 |
Mailing Address: | 123 Mearns Ave, HIGHLAND FALLS |
State: | NY |
Postal Code: | 109281009 |
Phone Number: | 7187814005 |
Fax Number: | 8459770244 |
NPI Enumeration Date: | 07/24/2007 |
NPI Last Update Date: | 01/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 076977 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |