Healthcare Provider Details

I. General information

NPI: 1346782828
Provider Name (Legal Business Name): MS. STEPHANIE WEBBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 12/23/2023
Certification Date: 12/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 BLUE HILL AVE
DORCHESTER CENTER MA
02124-2902
US

IV. Provider business mailing address

895 BLUE HILL AVE
DORCHESTER CENTER MA
02124-2902
US

V. Phone/Fax

Practice location:
  • Phone: 617-506-8188
  • Fax:
Mailing address:
  • Phone: 617-506-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: