Provider Demographics
NPI:1689475717
Name:STOCKERT, INDIA (MA)
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:STOCKERT
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:INDIA
Other - Middle Name:
Other - Last Name:BERCIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-1626
Mailing Address - Country:US
Mailing Address - Phone:218-693-2014
Mailing Address - Fax:218-693-2016
Practice Address - Street 1:203 14TH ST NE
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1626
Practice Address - Country:US
Practice Address - Phone:218-693-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional