Provider Demographics
NPI:1376519124
Name:STAMOS, CAROL A (MC, LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:STAMOS
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 N 16TH ST
Mailing Address - Street 2:SUITE # 213
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5251
Mailing Address - Country:US
Mailing Address - Phone:602-870-3800
Mailing Address - Fax:
Practice Address - Street 1:7227 N 16TH ST
Practice Address - Street 2:STE. 222
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5251
Practice Address - Country:US
Practice Address - Phone:602-870-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-2423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional