Provider Demographics
NPI:1750744231
Name:STAMPER, MELISSA K (LPCC, LICDC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:K
Last Name:STAMPER
Suffix:
Gender:F
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S HIGHVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5027
Mailing Address - Country:US
Mailing Address - Phone:513-423-6621
Mailing Address - Fax:513-423-9931
Practice Address - Street 1:10 S HIGHVIEW RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5027
Practice Address - Country:US
Practice Address - Phone:513-423-6621
Practice Address - Fax:513-423-9931
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH120632101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)