Provider Demographics
NPI:1740595503
Name:STOCKTON, LORI A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14174-9609
Mailing Address - Country:US
Mailing Address - Phone:716-754-8281
Mailing Address - Fax:716-286-7855
Practice Address - Street 1:4061 CREEK RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:NY
Practice Address - Zip Code:14174-9609
Practice Address - Country:US
Practice Address - Phone:716-754-8281
Practice Address - Fax:716-286-7855
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043271-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical