Provider Demographics
NPI:1194952580
Name:STANTON, CEDRIC DEWAYNE (NCC, LPC)
Entity type:Individual
Prefix:MR
First Name:CEDRIC
Middle Name:DEWAYNE
Last Name:STANTON
Suffix:
Gender:M
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 RED SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-4481
Mailing Address - Country:US
Mailing Address - Phone:256-350-5108
Mailing Address - Fax:256-350-5108
Practice Address - Street 1:1937 RED SUNSET DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4481
Practice Address - Country:US
Practice Address - Phone:256-350-5108
Practice Address - Fax:256-350-5108
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2438101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional