Provider Demographics
NPI:1225821697
Name:STAMPEN, JOHN OLAF
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:OLAF
Last Name:STAMPEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 N LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1333
Mailing Address - Country:US
Mailing Address - Phone:608-698-5282
Mailing Address - Fax:
Practice Address - Street 1:10012 W CAPITOL DR STE 101
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1300
Practice Address - Country:US
Practice Address - Phone:414-810-4844
Practice Address - Fax:414-810-4845
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)