Search › Alabama › 1041C0700X
Stephan Mambazo, MSW, LICSW-PIP, CGRS
NPI 1609263052 · on the registry since 2015 · sole proprietor
Practice
- Address
- 2541 College St
Montgomery, AL 36106 - Phone
- (334) 207-7657
- Organisation at this address
- Intellectualsoul Clinical Consulting, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 104100000X
- Licence states on file
- AL, PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-03-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alabama