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NPI Code Detail

MEDICARE: ALYSSA STEPHENS LCSW

MEDICARE: ALYSSA STEPHENS LCSW
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
11041C0700XClinical Social Worker8452CT

General Provider Information

NPI Number : 1295029585
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA STEPHENS LCSW
Provider Business Mailing Address
First Line : 135 MILL STONE DR
Second Line :
City : GUILFORD
State : CT
Zip : 06437-1085
Country : US
Telephone Number : 203-804-5514
Fax Number :
Provider Business Practice Location Address
First Line : 1000 LAFAYETTE BLVD STE 1100
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06604-4710
Country : US
Telephone Number : 646-941-7645
Fax Number : 929-596-7897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 05/15/2024

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Directions to “ ALYSSA STEPHENS LCSW” Practice Location

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