Provider Demographics
NPI:1902908270
Name:STANTON, MICHELE (LCSW-C)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:STANTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 WOODLAND CIR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5315
Mailing Address - Country:US
Mailing Address - Phone:443-789-1569
Mailing Address - Fax:
Practice Address - Street 1:946 NABBS CREEK RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8434
Practice Address - Country:US
Practice Address - Phone:180-030-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD080081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical