Provider Demographics
NPI:1073210068
Name:STOKES, CARL JR (LMSW, EDD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:STOKES
Suffix:JR
Gender:M
Credentials:LMSW, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1925
Mailing Address - Country:US
Mailing Address - Phone:716-473-2011
Mailing Address - Fax:
Practice Address - Street 1:19 LINDEN ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14206-1925
Practice Address - Country:US
Practice Address - Phone:716-473-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094149104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker