Provider Demographics
NPI:1164735783
Name:SIGNET, LUTICIA STOKER (LPC, NCC, PHD CAND)
Entity Type:Individual
Prefix:
First Name:LUTICIA
Middle Name:STOKER
Last Name:SIGNET
Suffix:
Gender:F
Credentials:LPC, NCC, PHD CAND
Other - Prefix:
Other - First Name:TISH
Other - Middle Name:STOKER
Other - Last Name:SIGNET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, NCC, PHD CAND
Mailing Address - Street 1:709 NORTHEAST DR
Mailing Address - Street 2:SUITE 22
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7430
Mailing Address - Country:US
Mailing Address - Phone:704-577-0006
Mailing Address - Fax:
Practice Address - Street 1:118 WISTERIA LN
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6695
Practice Address - Country:US
Practice Address - Phone:704-577-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2010-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7978101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor