Individual
SAMANTHA STUMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, TCADC
Contact information
Practice address
9575 KY HWY 122, SUITE 6, MCDOWELL, KY 41647-1614
(606) 949-1623
Mailing address
PO BOX 41, MC DOWELL, KY 41647-0041
(606) 359-0700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
283137
KY
106H00000X
Marriage & Family Therapist
Primary
276031
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100674370
—
KY
05
—
7100802100
—
KY
Enumeration date
05/16/2014
Last updated
03/01/2023
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