Individual
ERIC STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC, NCC
Contact information
Practice address
3176 LANCER ST, PORTAGE, IN 46368-4408
(219) 762-9557
Mailing address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39005580A
IN
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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