Healthcare Provider Details

I. General information

NPI: 1104742147
Provider Name (Legal Business Name): JULIE MICHELLE STOKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10961 BURNT MILL RD APT 723
JACKSONVILLE FL
32256-4669
US

IV. Provider business mailing address

10961 BURNT MILL RD APT 723
JACKSONVILLE FL
32256-4669
US

V. Phone/Fax

Practice location:
  • Phone: 724-814-0363
  • Fax:
Mailing address:
  • Phone: 724-814-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: