Provider Demographics
NPI:1124203021
Name:STOKES-WILLIAMS, CHARU (LICSW, BCD, PHD)
Entity Type:Individual
Prefix:
First Name:CHARU
Middle Name:
Last Name:STOKES-WILLIAMS
Suffix:
Gender:F
Credentials:LICSW, BCD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 14010
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96543-4010
Mailing Address - Country:US
Mailing Address - Phone:671-366-5125
Mailing Address - Fax:
Practice Address - Street 1:UNIT 14010
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96543-4010
Practice Address - Country:US
Practice Address - Phone:671-366-5125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MA216985104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA703136OtherTUFTS
MA172524OtherTRICARE
MA042611055OtherTAX ID
MAM18633OtherBLUE CROSS BLUE SHIELD
MA1303287OtherMBHP
MA00000023532OtherBMC
MA1004745OtherNHP
MA1303287Medicaid