Provider Demographics
NPI:1497377899
Name:NANETTE STOKES FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:NANETTE STOKES FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-359-1225
Mailing Address - Street 1:9321 WICKER AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-2300
Mailing Address - Country:US
Mailing Address - Phone:708-359-1225
Mailing Address - Fax:
Practice Address - Street 1:9321 WICKER AVE STE 205
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-2300
Practice Address - Country:US
Practice Address - Phone:708-359-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty