Provider Demographics
NPI:1053702555
Name:BLANCHE M STOKLEY, LMHC P.A.
Entity type:Organization
Organization Name:BLANCHE M STOKLEY, LMHC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BLANCHE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-691-0477
Mailing Address - Street 1:225 S SWOOPE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5786
Mailing Address - Country:US
Mailing Address - Phone:407-691-0477
Mailing Address - Fax:407-691-0484
Practice Address - Street 1:225 S SWOOPE AVE STE 205
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5786
Practice Address - Country:US
Practice Address - Phone:407-691-0477
Practice Address - Fax:407-691-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0002466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty