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NPI Code Detail

MEDICARE: DR. STEFFANIE BRACKETT PSY.D., BCBA-D

MEDICARE: DR. STEFFANIE BRACKETT PSY.D., BCBA-D
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
1103K00000XBehavior Analyst1-05-2296

General Provider Information

NPI Number : 1518253665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEFFANIE BRACKETT PSY.D., BCBA-D
Provider Business Mailing Address
First Line : 28 HARVEST DR
Second Line :
City : DERRY
State : NH
Zip : 03038-4872
Country : US
Telephone Number : 781-572-5564
Fax Number :
Provider Business Practice Location Address
First Line : 236 GANETT DRIVE
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-6913
Country : US
Telephone Number : 207-661-3600
Fax Number : 207-761-0783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2011
Last Update Date : 04/15/2026

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