Provider Demographics
NPI:1023664653
Name:STINSON, SALLY ORLIENE (MS)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:ORLIENE
Last Name:STINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UAB COMMUNITY PSYCHIATRY
Mailing Address - Street 2:908 20TH STREET SOUTH RM 487
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-934-9715
Mailing Address - Fax:205-975-8950
Practice Address - Street 1:UAB COMMUNITY PSYCHIATRY 908 20TH STREET SOUTH RM 487
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-9715
Practice Address - Fax:205-975-8950
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty