Provider Demographics
NPI:1114230745
Name:STOKEY, ADAM (MA, BCBA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:STOKEY
Suffix:
Gender:M
Credentials:MA, BCBA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N PALM AVE UNIT 33441
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-5018
Mailing Address - Country:US
Mailing Address - Phone:321-757-1353
Mailing Address - Fax:321-284-3525
Practice Address - Street 1:475 S JOHN RODES BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1093
Practice Address - Country:US
Practice Address - Phone:321-757-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-25
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst