MEDICARE: TERESA STOKES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1184131609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA STOKES

Provider Business Mailing Address
First Line	:	913 W HOLMES RD STE 275
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-0432
Country	:	US
Telephone Number	:	517-272-0520
Fax Number	:	517-272-0483

Provider Business Practice Location Address
First Line	:	756 TYVOLA RD STE 116
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-3535
Country	:	US
Telephone Number	:	517-977-4510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2018
Last Update Date	:	05/10/2024

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Directions to “ TERESA STOKES ” Practice Location

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