Healthcare Provider Details
I. General information
NPI: 1558129015
Provider Name (Legal Business Name): CLARETTA STOKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/11/2024
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 TYRONE ST
SPRINGFIELD MA
01104-1422
US
IV. Provider business mailing address
505 WASHINGTON ST APT E
WELLESLEY MA
02482-5926
US
V. Phone/Fax
- Phone: 857-212-7050
- Fax:
- Phone: 857-212-7050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101200000X |
| Taxonomy | Drama Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 102X00000X |
| Taxonomy | Poetry Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: