Provider Demographics
NPI:1467691543
Name:STOVALL, SREELA ROY (MS)
Entity Type:Individual
Prefix:
First Name:SREELA
Middle Name:ROY
Last Name:STOVALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SREELA
Other - Middle Name:ROY
Other - Last Name:STOVALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:132 GARNETT LN
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9538
Mailing Address - Country:US
Mailing Address - Phone:185-364-9459
Mailing Address - Fax:
Practice Address - Street 1:2215 BURDETT AVE
Practice Address - Street 2:BEHAVIORAL HEALTH DEPT
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2466
Practice Address - Country:US
Practice Address - Phone:518-271-3374
Practice Address - Fax:518-271-3682
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health