Healthcare Provider Details

I. General information

NPI: 1316538630
Provider Name (Legal Business Name): HOLLY STOKES MA & PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 KRISTINA WAY
CHESAPEAKE VA
23320-8917
US

IV. Provider business mailing address

6617 GLENOAK DR
NORFOLK VA
23513-3123
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0153
  • Fax:
Mailing address:
  • Phone: 757-609-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0606822
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: