Provider Demographics
NPI:1912373309
Name:STOKES, SHANA L (LAPC)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:L
Last Name:STOKES
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MIZE ST
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-3346
Mailing Address - Country:US
Mailing Address - Phone:706-638-5591
Mailing Address - Fax:706-639-2054
Practice Address - Street 1:501 MIZE ST
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-3346
Practice Address - Country:US
Practice Address - Phone:706-638-5591
Practice Address - Fax:706-639-2054
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional