Provider Demographics
NPI:1427203645
Name:STILES, VICKI K (LPCC)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:K
Last Name:STILES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 34 BOX 2GG
Mailing Address - Street 2:
Mailing Address - City:SAPELLO
Mailing Address - State:NM
Mailing Address - Zip Code:87745
Mailing Address - Country:US
Mailing Address - Phone:505-425-9062
Mailing Address - Fax:
Practice Address - Street 1:714 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4228
Practice Address - Country:US
Practice Address - Phone:505-425-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0115881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional