Provider Demographics
NPI:1699437244
Name:STUBLER, MICHAEL J (LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:STUBLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3244
Mailing Address - Country:US
Mailing Address - Phone:814-502-5531
Mailing Address - Fax:814-201-2583
Practice Address - Street 1:705 12TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2419
Practice Address - Country:US
Practice Address - Phone:814-944-9970
Practice Address - Fax:814-201-2583
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional