Healthcare Provider Details

I. General information

NPI: 1225624562
Provider Name (Legal Business Name): MISS YVETTE STEPHAINE RYLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YVETTE STEPHAINE RYLES YVETTE RYLES

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HIGH ST STE 230
SPRINGFIELD MA
01105-1435
US

IV. Provider business mailing address

140 HIGH ST STE 230
SPRINGFIELD MA
01105-1435
US

V. Phone/Fax

Practice location:
  • Phone: 978-651-1963
  • Fax:
Mailing address:
  • Phone: 987-651-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: