Provider Demographics
NPI:1952511982
Name:STUMPF, JOHN STANLEY (MS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STANLEY
Last Name:STUMPF
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ROUTE 522
Mailing Address - Street 2:SELINSGROVE CENTER
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-8707
Mailing Address - Country:US
Mailing Address - Phone:570-372-5974
Mailing Address - Fax:
Practice Address - Street 1:1000 ROUTE 522
Practice Address - Street 2:SELINSGROVE CENTER
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8707
Practice Address - Country:US
Practice Address - Phone:570-372-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008044L103T00000X, 103TB0200X, 103TC1900X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities