Provider Demographics
NPI:1831879477
Name:STOKES, VESTINA
Entity type:Individual
Prefix:
First Name:VESTINA
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 TERANCE AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-7891
Mailing Address - Country:US
Mailing Address - Phone:770-750-4220
Mailing Address - Fax:
Practice Address - Street 1:831 FAIRWAYS CT STE A
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7278
Practice Address - Country:US
Practice Address - Phone:770-389-1925
Practice Address - Fax:770-389-3077
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional