Individual provider · Type 1 NPI
Samantha Stack, LCPC
Mental Health Counselor · Chicago, IL
NPI number
1811380835
Active
Practice location
3301 W 111th St
Chicago, IL 60655-2715
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | None listed |
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1811380835
Samantha Stack, LCPC's National Provider Identifier is 1811380835, issued on Mar 16, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on Dec 1, 2020.