Provider Demographics
NPI:1780087569
Name:STAMAS, TOM (LCPC, CADC)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:
Last Name:STAMAS
Suffix:
Gender:M
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E 22ND ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4976
Mailing Address - Country:US
Mailing Address - Phone:630-495-2014
Mailing Address - Fax:
Practice Address - Street 1:2 E 22ND ST
Practice Address - Street 2:SUITE 302
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4976
Practice Address - Country:US
Practice Address - Phone:630-495-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011717101YA0400X
IL178006683101YA0400X, 101YP2500X
IL180011717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)