Healthcare Provider Details

I. General information

NPI: 1831390285
Provider Name (Legal Business Name): SALLEE ANN STEARNS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PRESCOTT ST STE 3300
WORCESTER MA
01605-2652
US

IV. Provider business mailing address

50 PRESCOTT ST STE 3300
WORCESTER MA
01605-2652
US

V. Phone/Fax

Practice location:
  • Phone: 508-890-6411
  • Fax: 508-890-6411
Mailing address:
  • Phone: 508-890-6411
  • Fax: 508-890-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113423
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: