Provider Demographics
NPI:1144052085
Name:STOKES, ANNIE M (LMSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:M
Last Name:STOKES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:M
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1380 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4254
Mailing Address - Country:US
Mailing Address - Phone:208-523-2490
Mailing Address - Fax:208-522-2603
Practice Address - Street 1:1301 MAIN ST STE 3B
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467-4452
Practice Address - Country:US
Practice Address - Phone:208-756-2927
Practice Address - Fax:208-756-1518
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5961566104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker