Healthcare Provider Details

I. General information

NPI: 1700687910
Provider Name (Legal Business Name): STEPHANIE L. BETTENCOURT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 FAUNCE CORNER RD
DARTMOUTH MA
02747-1242
US

IV. Provider business mailing address

581 FAUNCE CORNER RD
DARTMOUTH MA
02747-1242
US

V. Phone/Fax

Practice location:
  • Phone: 508-207-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2303055
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: