MEDICARE: STEPHANIE TUBBS

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	1041C0700X	Clinical Social Worker	C10500	MS
2	1041C0700X	Clinical Social Worker	135610	CA
3	1041C0700X	Clinical Social Worker	13597854-3504	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER		NA

General Provider Information

NPI Number	:	1396444071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE TUBBS

Provider Business Mailing Address
First Line	:	1805 SCHOOL ST
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3049
Country	:	US
Telephone Number	:	228-761-6314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 SCHOOL ST
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3049
Country	:	US
Telephone Number	:	228-761-6314
Fax Number	:

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

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	01/21/2026

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Directions to “ STEPHANIE TUBBS ” Practice Location

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