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General NPI Number Information
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NPI Number | 1568852564
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Entity Type | Organization
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Legal Business Name | STEPHEN S. MUGGEO PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 9 S ANGELL ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-5226
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Country | US
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Telephone | 401-525-8436
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Fax |
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Provider Business Mailing Address
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Address Line | 9 S ANGELL ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-5226
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Country | US
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Telephone | 401-525-8436
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | STEPHEN S MUGGEO
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Credential | LCSW
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Telephone | 203-274-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8437
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License Number State | CT
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