Gary D. Stanforth,ltd.,msw.,lisw.,licdc

NPI #1700966942 in Franklin, Ohio

Provider Information

NPI Number: 1700966942
Entity Type: Organization
Organization Name: Gary D. Stanforth,ltd.,msw.,lisw.,licdc
Primary Specialty: Counselor - Mental Health
Enumeration Date: Oct 16, 2006
Last Updated: Jan 15, 2009

Practice Location

Address: 8401 CLAUDE THOMAS RD
Address 2: SUITE 21 F
City: Franklin
State: Ohio
ZIP Code: 45005-1497
Phone: (515) 535-7668

Authorized Official

Name: MR. GARY D. STANFORTH, L.I.S.W, L.I.C.D.C.
Title: ADDICTIONS/MENTAL HEALTH COUNSELOR
Phone: (513) 535-7668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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