MEDICARE: MS. ANTENETTE DO'LYN STOKES LPC, NCC, QMHP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0733002751	VA
2	101YP2500X	Professional Counselor	0701011004	VA

General Provider Information

NPI Number	:	1841956596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANTENETTE DO'LYN STOKES LPC, NCC, QMHP-C

Provider Business Mailing Address
First Line	:	4027 MACARTHUR AVE APT 4
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4062
Country	:	US
Telephone Number	:	804-239-0229
Fax Number	:	833-399-1090

Provider Business Practice Location Address
First Line	:	4027 MACARTHUR AVE APT 4
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4062
Country	:	US
Telephone Number	:	804-239-0229
Fax Number	:	833-390-1090

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2021
Last Update Date	:	11/16/2021

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