Mambazo, Stephan Idris

Mambazo, Stephan Idris is an sole proprietor health care provider with primary practice located at 2541 College St , Montgomery AL 36106-2124. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Mambazo, Stephan Idris can be contacted via phone (334) 207-7657.

Contact Information

Primary practice address
2541 College St Montgomery AL 36106-2124
Phone: (334) 207-7657
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3796C Alabama
Behavioral Health & Social Service Providers / Social Worker 104100000X SW009851L Pennsylvania

Profile Details

NPI number 1609263052
LBN Legal business name Mambazo, Stephan Idris
Credentials MSW, LICSW-PIP, CGRS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2015
Last updated Mar 1st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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