Provider Demographics
NPI:1518229566
Name:STUMPE, MARY ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:STUMPE
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 1:801 CHURCH ST NE
Mailing Address - Street 2:STE 7
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-2472
Mailing Address - Country:US
Mailing Address - Phone:256-274-8222
Mailing Address - Fax:855-732-2497
Practice Address - Street 1:801 CHURCH ST NE
Practice Address - Street 2:STE 7
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2472
Practice Address - Country:US
Practice Address - Phone:256-274-8222
Practice Address - Fax:855-732-2497
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3302101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor