1902285125 NPI number — MRS. ANN CAMILLE STOKES LMSW CAADC

Table of content: MRS. ANN CAMILLE STOKES LMSW CAADC (NPI 1902285125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902285125 NPI number — MRS. ANN CAMILLE STOKES LMSW CAADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOKES
Provider First Name:
ANN
Provider Middle Name:
CAMILLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW CAADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BALDONI
Provider Other First Name:
ANN
Provider Other Middle Name:
CAMILLE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LLMSW CAADC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902285125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
418 W KALAMAZOO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49007-3334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-553-7120
Provider Business Mailing Address Fax Number:
269-553-7129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
418 W KALAMAZOO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KALAMAZOO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49007-3334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-553-7120
Provider Business Practice Location Address Fax Number:
269-553-7129
Provider Enumeration Date:
05/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6801109289 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com