Healthcare Provider Details

I. General information

NPI: 1487625083
Provider Name (Legal Business Name): DENISE S. DUPLESSIS MS, PCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 W MAIN ST
DUDLEY MA
01571
US

IV. Provider business mailing address

PO BOX 40
SOUTHBRIDGE MA
01550-0040
US

V. Phone/Fax

Practice location:
  • Phone: 508-765-9167
  • Fax:
Mailing address:
  • Phone: 508-909-7799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRNCNS21791
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN21791
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberPPNS0040
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN166154
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: