Provider Demographics
NPI:1962274712
Name:CIANO, STACY JO (LCSW-C)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:JO
Last Name:CIANO
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 1:53 ALLISON WAY
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-7051
Mailing Address - Country:US
Mailing Address - Phone:907-304-1001
Mailing Address - Fax:
Practice Address - Street 1:53 ALLISON WAY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-7051
Practice Address - Country:US
Practice Address - Phone:907-304-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD262141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical