Healthcare Provider Details

I. General information

NPI: 1225941883
Provider Name (Legal Business Name): LAURA LOUISE STOKER ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA LOUISE EVANS

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 E CENTER ST
FAIRVIEW UT
84629-5575
US

IV. Provider business mailing address

258 E CENTER ST
FAIRVIEW UT
84629-5575
US

V. Phone/Fax

Practice location:
  • Phone: 402-760-0045
  • Fax:
Mailing address:
  • Phone: 402-760-0045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number143446216009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: