Provider Demographics
NPI:1699571695
Name:STOKESBERRY, SAMANTHA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:STOKESBERRY
Suffix:
Gender:
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14900 AVERY RANCH BLVD
Mailing Address - Street 2:C-200 BOX 199
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717
Mailing Address - Country:US
Mailing Address - Phone:512-971-5003
Mailing Address - Fax:
Practice Address - Street 1:507 DENALI PASS STE 301
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7979
Practice Address - Country:US
Practice Address - Phone:512-971-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89819101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional