Provider Demographics
NPI:1811698137
Name:STOCKS, JOHN VINCENT IV (LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:VINCENT
Last Name:STOCKS
Suffix:IV
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DODGINGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1622
Mailing Address - Country:US
Mailing Address - Phone:203-885-6773
Mailing Address - Fax:
Practice Address - Street 1:32 POVERTY RD STE F
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2386
Practice Address - Country:US
Practice Address - Phone:203-598-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.006170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional