Healthcare Provider Details

I. General information

NPI: 1972662468
Provider Name (Legal Business Name): JAMES EDWARD STOCKWELL LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 S MAIN ST SUITE 203
TOPSFIELD MA
01983-1800
US

IV. Provider business mailing address

42 ANDERSON DR
BOXFORD MA
01921-1409
US

V. Phone/Fax

Practice location:
  • Phone: 978-887-5546
  • Fax: 978-887-5546
Mailing address:
  • Phone: 978-887-5546
  • Fax: 978-887-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1029745
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: