Provider Demographics
NPI:1861775561
Name:STOKES, MICHAEL III (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:STOKES
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4019
Mailing Address - Country:US
Mailing Address - Phone:203-910-4904
Mailing Address - Fax:203-723-0702
Practice Address - Street 1:16 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4019
Practice Address - Country:US
Practice Address - Phone:203-910-4904
Practice Address - Fax:203-723-0702
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002101101YP2500X
RIMHC01167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health