Diane L Stamper, MS, LPC

Individual provider Active NPI Mental Health Counselor · Phoenix, OR

NPI 1053661710 · NPPES record last updated Sep 10, 2012

Key facts

NPI
1053661710
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
C1746 (OR)
Practice address
164 Meadow View Dr
Phoenix, OR 97535-9431
Phone
(541) 261-5440
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C1746ORMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C1746 OR Yes
Professional Counselor 101YP2500X C1746 OR

Addresses

Primary practice location

164 Meadow View Dr
Phoenix, OR 97535-9431

Mailing address

164 Meadow View Dr
Phoenix, OR 97535-9431
Phone (541) 261-5440

Other providers in Phoenix, OR

All providers in Phoenix, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.