Provider Demographics
NPI:1558402321
Name:EUBANKS, STELLA VIRGINIA (LPC LSATP LMFT)
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:VIRGINIA
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:LPC LSATP LMFT
Other - Prefix:MRS
Other - First Name:STELLA
Other - Middle Name:EUBANKS
Other - Last Name:VAN GUILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC CRC CCS PART
Mailing Address - Street 1:823 HIGH POINT AVE
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451
Mailing Address - Country:US
Mailing Address - Phone:757-421-8627
Mailing Address - Fax:
Practice Address - Street 1:1417 N BATTLEFIELD
Practice Address - Street 2:#260 COASTAL COUNSELING CENTER
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-436-0605
Practice Address - Fax:757-436-0023
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002500101Y00000X
VA0718000088101YA0400X
VA0717000699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist