Provider Demographics
NPI:1093059990
Name:STOKES, SAMANTHA J (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:J
Last Name:STOKES
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1323
Mailing Address - Street 2:
Mailing Address - City:STERLING CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76951-1323
Mailing Address - Country:US
Mailing Address - Phone:325-650-4083
Mailing Address - Fax:
Practice Address - Street 1:19 S PARK ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3471
Practice Address - Country:US
Practice Address - Phone:325-650-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67151101YP2500X
TX347682355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67151OtherSTATE LICENSE