Provider Demographics
NPI:1023386299
Name:POWER, STEPHANIE K (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:POWER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CHICKERING LN
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-2101
Mailing Address - Country:US
Mailing Address - Phone:617-462-4494
Mailing Address - Fax:
Practice Address - Street 1:4 CHICKERING LN
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-2101
Practice Address - Country:US
Practice Address - Phone:617-462-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2174341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical