Provider Demographics
NPI:1801001151
Name:SAPPINGTON, HARRY (SAM) WELLS III (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARRY (SAM)
Middle Name:WELLS
Last Name:SAPPINGTON
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:HW
Other - Last Name:SAPPINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:4877 NW SOX LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-9370
Mailing Address - Country:US
Mailing Address - Phone:541-928-7556
Mailing Address - Fax:541-928-7556
Practice Address - Street 1:260 SW MADISON AVE.
Practice Address - Street 2:SUITE #107
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4728
Practice Address - Country:US
Practice Address - Phone:541-602-4369
Practice Address - Fax:541-368-4325
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1449103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling