Provider Demographics
NPI:1982278917
Name:STOKES, CASEY NICOLE (BS, CSAC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:NICOLE
Last Name:STOKES
Suffix:
Gender:F
Credentials:BS, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 CIRCUIT LN APT C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-2900
Mailing Address - Country:US
Mailing Address - Phone:919-931-2629
Mailing Address - Fax:
Practice Address - Street 1:357 CIRCUIT LN APT C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-2900
Practice Address - Country:US
Practice Address - Phone:919-931-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103438101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)