Healthcare Provider Details

I. General information

NPI: 1124885280
Provider Name (Legal Business Name): ALAN JAMES STAMPER LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PARK AVE STE 602
WORCESTER MA
01609-1930
US

IV. Provider business mailing address

6 CONGRESS ST APT 2
WORCESTER MA
01609-3194
US

V. Phone/Fax

Practice location:
  • Phone: 508-344-7530
  • Fax: 508-466-8282
Mailing address:
  • Phone: 781-201-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: