Provider Demographics
NPI:1154143295
Name:STOCKS, KATHRYN (LPC, SAC-IT, NCC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:STOCKS
Suffix:
Gender:F
Credentials:LPC, SAC-IT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 W DEER RUN DR APT 101
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6410
Mailing Address - Country:US
Mailing Address - Phone:414-559-0054
Mailing Address - Fax:
Practice Address - Street 1:4530 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53211-1215
Practice Address - Country:US
Practice Address - Phone:414-559-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11206-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health