MR. MARK JUDE STANFORD (NPI# 1073879649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073879649 |
| Entity Type | Individual |
| Full Name | MR. MARK JUDE STANFORD |
| Credential | LCSW |
| Practice Address |
1003 Hugh Wallis Rd S C-6 Lafayette LA 70508-2528 |
| Mailing Address |
112 Howard Ave Lafayette LA 70506-4402 |
| Practice Telephone | 3373441617 |
| Mailing Telephone | 3373441617 |
| Mailing Fax Number | 3372899336 |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2012-04-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
10658 | LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LCSW LICENSE # | 10658 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376544676 | Mark M. Stanford | Dentist | 960 Pleasant Valley Way, West Orange, NJ 07052-1803 | 2005-08-09 |
| 1942333851 | Mark A Stanford | Dentist | 34441 8 Mile Rd, Suite 114, Livonia, MI 48152-4013 | 2007-03-13 |
| 1003897059 | Mark W Stanford | Emergency Medicine | 300 Pinellas St, Morton Plant Hospital, Clearwater, FL 33756-3804 | 2005-11-08 |
| Street Address |
1003 HUGH WALLIS RD S C-6 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-2528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674124 | Eric Paul Baquet | Behavioral Analyst | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2020-09-18 |
| 1407481351 | Sophie Doucet | Behavioral Analyst | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2020-03-10 |
| 1003460395 | Marquita Melissa Cunningham | Case Manager/Care Coordinator | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2019-07-25 |
| 1679131676 | Kimberly E Gordon | Behavioral Analyst | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2019-06-04 |
| 1467010652 | Starlea Marie Biggs | Behavioral Analyst | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2019-06-03 |
| 1376101568 | Cornell Lamont Thorn Jr. | Behavior Technician | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2019-06-03 |
| 1245707249 | Samantha Faye Rushlow | Behavior Technician | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2018-10-28 |
| 1710468467 | Marissa Winters | Behavioral Analyst | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2018-08-21 |
| 1013494715 | Ciasha Marie Roberts | Behavior Technician | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2018-07-25 |
| 1356833180 | Ebony Alexander | Behavior Technician | 1003 Hugh Wallis Rd S, Lafayette, LA 70508-2528 | 2018-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479874 | Lisa Cannon Counseling, LLC | Social Worker | 534 S 9th St, Lafayette, IN 47901-1727 | 2020-08-26 |
| 1265045900 | Amber M. Roter | Social Worker | 588 N Us-287 Co, Suite 200, Lafayette, CO 80026 | 2020-08-24 |
| 1871104208 | The Therapy Garden | Social Worker | 119 Ridgeway Dr Ste B1, Lafayette, LA 70503-3446 | 2020-08-10 |
| 1437769064 | Natalie Bunner | Social Worker | 107 Global Cir, Lafayette, LA 70503-5319 | 2020-08-07 |
| 1104464197 | Rebecca Oyer, Msw, Lcsw, Sep, LLC | Social Worker | 143 Ridgeway Dr Ste 101, Lafayette, LA 70503-3410 | 2019-12-20 |
| 1740827104 | Melissa T Vidrine | Social Worker | 345 Doucet Rd Ste 226, Lafayette, LA 70503-3490 | 2019-12-04 |
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1871141663 | Jayme Liles | Social Worker | 200 Claymore Dr, Lafayette, LA 70503-3834 | 2019-08-27 |
| 1821650987 | Kathryn Dietzway | Social Worker | 345 Doucet Rd Ste 217, Lafayette, LA 70503-3488 | 2019-06-28 |
| 1861952210 | Laura Willenborg Counseling LLC | Social Worker | 1000 Sagamore Pkwy N Ste 207, Lafayette, IN 47904-2474 | 2019-03-21 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.