Provider Demographics
NPI:1871275339
Name:STINGER, BILL LEROY JR (LMSW)
Entity type:Individual
Prefix:
First Name:BILL
Middle Name:LEROY
Last Name:STINGER
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6465
Mailing Address - Country:US
Mailing Address - Phone:208-406-2922
Mailing Address - Fax:
Practice Address - Street 1:209 E LEWIS ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6465
Practice Address - Country:US
Practice Address - Phone:208-406-2922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-43946104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker