Provider Demographics
NPI:1235160755
Name:STOKES, CLAUSELL JR (LCDC)
Entity Type:Individual
Prefix:MR
First Name:CLAUSELL
Middle Name:
Last Name:STOKES
Suffix:JR
Gender:M
Credentials:LCDC
Other - Prefix:MR
Other - First Name:CLAUSELL
Other - Middle Name:
Other - Last Name:STOKES
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:LCDC
Mailing Address - Street 1:9896 BISSONNET ST
Mailing Address - Street 2:SUITE # 465
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8104
Mailing Address - Country:US
Mailing Address - Phone:713-981-0922
Mailing Address - Fax:713-981-0222
Practice Address - Street 1:9896 BISSONNET ST
Practice Address - Street 2:SUITE # 465
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8104
Practice Address - Country:US
Practice Address - Phone:713-981-0922
Practice Address - Fax:713-981-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
TX2647101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2647OtherLICENSED CHEMICAL DEPENDENCY COUNSELOR (LCDC)