Healthcare Provider Details

I. General information

NPI: 1891190807
Provider Name (Legal Business Name): STEFANIE SHIPPEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 N MAIN ST
FLORENCE MA
01062-1287
US

IV. Provider business mailing address

PO BOX 360
HATFIELD MA
01038-0360
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-5555
  • Fax:
Mailing address:
  • Phone: 413-446-8044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number413352
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: