Provider Demographics
NPI:1205250230
Name:STAPOR, ALISHA (LPC, NCC, LLMFT)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:
Last Name:STAPOR
Suffix:
Gender:F
Credentials:LPC, NCC, LLMFT
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC, LLMFT
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-0111
Mailing Address - Country:US
Mailing Address - Phone:231-238-2172
Mailing Address - Fax:231-238-2173
Practice Address - Street 1:4071 S STRAITS HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-8407
Practice Address - Country:US
Practice Address - Phone:231-238-2172
Practice Address - Fax:231-238-2173
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013049101Y00000X
MI4101006600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist