Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephan Idris Mambazo, MSW, LICSW-PIP, CGRS

Individual provider Clinical Social Worker · NPI 1609263052

Stephan Idris Mambazo, MSW, LICSW-PIP, CGRS is a Clinical Social Worker in Montgomery, Alabama. Practices as a sole proprietor. Licensed in Alabama and Pennsylvania.

Licensed in
AL, PA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.

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Practice location Address checks out

2541 College St
Montgomery, AL 36106-2124
Phone: (334) 207-7657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 3796C (AL)
Social Worker Taxonomy 104100000X · Licence SW009851L (PA)

Record details

NPI number1609263052
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW-PIP , CGRS
Sole proprietorYes
NPI enumeratedApril 23, 2015
Last updated in NPPESMarch 1, 2017

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