Provider Demographics
NPI:1023817210
Name:STANLEY, JERRICA L (LICSW)
Entity type:Individual
Prefix:
First Name:JERRICA
Middle Name:L
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 WOODYARD CIR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4391
Mailing Address - Country:US
Mailing Address - Phone:240-391-8814
Mailing Address - Fax:
Practice Address - Street 1:9705 WOODYARD CIR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4391
Practice Address - Country:US
Practice Address - Phone:240-391-8814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000013861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical