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General NPI Number Information
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NPI Number | 1225821697
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Entity Type | Individual
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Provider Name | JOHN OLAF STAMPEN
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Gender | Male
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 10012 W CAPITOL DR STE 101
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City | MILWAUKEE
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State | WI
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Zip | 53222-1300
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Country | US
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Telephone | 414-810-4844
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Fax | 414-810-4845
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Provider Business Mailing Address
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Address Line | 2044 N LAKE DR
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City | MILWAUKEE
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State | WI
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Zip | 53202-1333
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Country | US
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Telephone | 608-698-5282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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