Provider Demographics
NPI:1215058193
Name:STOCKTON, TIMOTHY RAY (LPCC,NCC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:RAY
Last Name:STOCKTON
Suffix:
Gender:M
Credentials:LPCC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-2761
Mailing Address - Country:US
Mailing Address - Phone:606-307-6688
Mailing Address - Fax:
Practice Address - Street 1:840 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2760
Practice Address - Country:US
Practice Address - Phone:606-307-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional