Provider Demographics
NPI:1992328173
Name:STAMATOUKOS, MARIA (LMCHC-A)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:STAMATOUKOS
Suffix:
Gender:F
Credentials:LMCHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5803
Mailing Address - Country:US
Mailing Address - Phone:828-638-9006
Mailing Address - Fax:
Practice Address - Street 1:116 LEE ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3839
Practice Address - Country:US
Practice Address - Phone:704-487-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NCA17411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician