Provider Demographics
NPI:1942617618
Name:STOKES-MILLER, REGINA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:MARIE
Last Name:STOKES-MILLER
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 1:1108 SHERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8069
Mailing Address - Country:US
Mailing Address - Phone:484-614-9474
Mailing Address - Fax:
Practice Address - Street 1:110 E STATE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3100
Practice Address - Country:US
Practice Address - Phone:610-331-8371
Practice Address - Fax:610-444-4530
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1942617618Medicare PIN