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General NPI Number Information
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NPI Number | 1609425529
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Entity Type | Individual
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Provider Name | JUANITA PATRICIA STOKES LPC
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Gender | Female
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 14999 BIRCHDALE AVE
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1317
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Country | US
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Telephone | 703-903-9696
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Fax |
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Provider Business Mailing Address
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Address Line | 16602 ACCOLON CT
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City | DUMFRIES
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State | VA
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Zip | 22025-3129
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Country | US
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Telephone | 703-670-4427
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701008187
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License Number State | VA
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