Provider Demographics
NPI:1124476767
Name:STAMMLER, MICHELLE (LCSW, LISW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:STAMMLER
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12472 LAKE UNDERHILL RD STE 514
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7144
Mailing Address - Country:US
Mailing Address - Phone:689-710-3276
Mailing Address - Fax:
Practice Address - Street 1:12472 LAKE UNDERHILL RD
Practice Address - Street 2:PMB 514
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7144
Practice Address - Country:US
Practice Address - Phone:689-710-3276
Practice Address - Fax:855-944-3420
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0795971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical