Healthcare Provider Details

I. General information

NPI: 1023815677
Provider Name (Legal Business Name): KRISTIN MARIE STELTER LICSW, MFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 FR DEVALLES BLVD STE 15
FALL RIVER MA
02723-1519
US

IV. Provider business mailing address

170 DARLINGDALE AVE APT 1R
PAWTUCKET RI
02861-5910
US

V. Phone/Fax

Practice location:
  • Phone: 508-264-7838
  • Fax:
Mailing address:
  • Phone: 734-709-7801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04374
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: