Healthcare Provider Details

I. General information

NPI: 1538828033
Provider Name (Legal Business Name): STOKES COUNSELING AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2021
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LOOKOUT PL STE 220
MAITLAND FL
32751-8440
US

IV. Provider business mailing address

220 LOOKOUT PL STE 220
MAITLAND FL
32751-8440
US

V. Phone/Fax

Practice location:
  • Phone: 407-758-2929
  • Fax:
Mailing address:
  • Phone: 407-758-2929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMIAH THOMAS STOKES
Title or Position: PSYCHOTHERAPIST
Credential: ED.D., LMHC
Phone: 407-758-2929