| Kimberly Stokes, LPC | |
| 1169 Wyoming Ave, Forty Fort, PA 18704-4003 | |
| (570) 762-9592 | |
| Not Available | 
| Full Name | Kimberly Stokes | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 1169 Wyoming Ave, Forty Fort, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1003573163 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC004335 (Pennsylvania) | Primary | 
| Entity Name | Thaxton Holistic Wellness Center | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1609243898 PECOS PAC ID: 2769818418 Enrollment ID: O20200129000324 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kimberly Stokes, LPC 1169 Wyoming Ave, Forty Fort, PA 18704-4003 Ph: () - | Kimberly Stokes, LPC 1169 Wyoming Ave, Forty Fort, PA 18704-4003 Ph: (570) 762-9592 | 
| George Mercurio,  Counselor Medicare: Medicare Enrolled Practice Location: 1169 Wyoming Ave, Forty Fort, PA 18704 Phone: 570-904-7363 Fax: 570-348-4079 | |
| Tiffani Gebhardt,  Counselor Medicare: Medicare Enrolled Practice Location: 1169 Wyoming Ave, Forty Fort, PA 18704 Phone: 570-904-7363 Fax: 570-348-4079 | |
| Allyson Nichole Villella,  Counselor Medicare: Medicare Enrolled Practice Location: 1169 Wyoming Ave, Forty Fort, PA 18704 Phone: 570-904-7363 Fax: 570-348-4079 | |
| Jackalynn Wilson,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 1169 Wyoming Ave, Forty Fort, PA 18704 Phone: 570-904-7363 | |
| Ms. Jeanne Ann Grymko, L.P.C., C.A.A.D.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 15 E Turner St, Forty Fort, PA 18704 Phone: 570-313-6449 | |
| Chelsee Firestone, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1169 Wyoming Ave, Forty Fort, PA 18704 Phone: 570-904-3699 Fax: 570-227-1591 |