MEDICARE: STEPHANIE PAMELA BIANCHINI 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
1	1041C0700X	Clinical Social Worker	125371	MA
2	1041C0700X	Clinical Social Worker	CW021700	PA

General Provider Information

NPI Number	:	1780101428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE PAMELA BIANCHINI LCSW

Provider Business Mailing Address
First Line	:	59 INDIAN WIND DR
Second Line	:
City	:	SCITUATE
State	:	MA
Zip	:	02066-3025
Country	:	US
Telephone Number	:	339-236-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 WASHINGTON ST STE 8
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-1662
Country	:	US
Telephone Number	:	215-792-4138
Fax Number	:

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

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	04/20/2024

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