MEDICARE: MR. STEPHEN LIGHT LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	1469	MA

General Provider Information

NPI Number	:	1215353321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN LIGHT LMFT

Provider Business Mailing Address
First Line	:	31 HAYWARD ST
Second Line	:	STE. H2
City	:	FRANKLIN
State	:	MA
Zip	:	02038-2166
Country	:	US
Telephone Number	:	774-300-9113
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 HAYWARD ST
Second Line	:	STE. H2
City	:	FRANKLIN
State	:	MA
Zip	:	02038-2166
Country	:	US
Telephone Number	:	774-300-9113
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	03/13/2014

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Directions to “ MR. STEPHEN LIGHT LMFT” Practice Location

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