Provider Demographics
NPI:1609810035
Name:STOKES, M. ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:M. ELIZABETH
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 WALNUT ST
Mailing Address - Street 2:SUITE 1706
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3604
Mailing Address - Country:US
Mailing Address - Phone:215-266-4066
Mailing Address - Fax:215-893-9350
Practice Address - Street 1:1528 WALNUT ST
Practice Address - Street 2:SUITE 1706
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3604
Practice Address - Country:US
Practice Address - Phone:215-266-4066
Practice Address - Fax:215-893-9350
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 008624-L103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA028317Medicare ID - Type Unspecified