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General NPI Number Information
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NPI Number | 1336233824
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Entity Type | Organization
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Legal Business Name | CONSTANCE S. STAMPER, MSW, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 501 W BRISTOL ST
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City | ELKHART
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State | IN
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Zip | 46514-2964
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Country | US
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Telephone | 574-266-1891
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Fax |
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Provider Business Mailing Address
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Address Line | 1534 GREENLEAF BLVD
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City | ELKHART
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State | IN
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Zip | 46514-3721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CONSTANCE STAMPER
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Credential | MSW, LCSW
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Telephone | 574-266-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004269A
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License Number State | IN
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