Provider Demographics
NPI:1740684539
Name:STOKES, JEREMIAH I (LMHC)
Entity type:Individual
Prefix:MR
First Name:JEREMIAH
Middle Name:
Last Name:STOKES
Suffix:I
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LOOKOUT PL STE 220
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-8440
Mailing Address - Country:US
Mailing Address - Phone:407-758-2929
Mailing Address - Fax:
Practice Address - Street 1:220 LOOKOUT PL STE 220
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8440
Practice Address - Country:US
Practice Address - Phone:407-758-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health