Healthcare Provider Details

I. General information

NPI: 1245134923
Provider Name (Legal Business Name): MRS. JACHELL P STOKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MARSHALL AVE STE 900
LAUREL MD
20707-4864
US

IV. Provider business mailing address

6405 ROCKLEDGE CT
ELKRIDGE MD
21075-5448
US

V. Phone/Fax

Practice location:
  • Phone: 800-994-5403
  • Fax: 443-378-8436
Mailing address:
  • Phone: 443-673-2413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18630
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: