Provider Demographics
NPI:1235942640
Name:ROLFE, STACIE (LICSW)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:ROLFE
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 1:117 MARY CAUDLE WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-6603
Mailing Address - Country:US
Mailing Address - Phone:256-453-4698
Mailing Address - Fax:
Practice Address - Street 1:117 MARY CAUDLE WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-6603
Practice Address - Country:US
Practice Address - Phone:256-453-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6096C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical