Provider Demographics
NPI:1225789530
Name:STALLMAN, SOMMER (LPC)
Entity Type:Individual
Prefix:
First Name:SOMMER
Middle Name:
Last Name:STALLMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0655
Mailing Address - Country:US
Mailing Address - Phone:897-369-8159
Mailing Address - Fax:
Practice Address - Street 1:416 N M 129
Practice Address - Street 2:
Practice Address - City:PICKFORD
Practice Address - State:MI
Practice Address - Zip Code:49774-9204
Practice Address - Country:US
Practice Address - Phone:906-647-2217
Practice Address - Fax:906-647-2228
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 101Y00000X
MI6451019418101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional