Provider Demographics
NPI:1093812745
Name:HANCOX, STEPHANIE (PSYD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HANCOX
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3505
Mailing Address - Country:US
Mailing Address - Phone:978-388-5875
Mailing Address - Fax:978-388-6648
Practice Address - Street 1:3 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3505
Practice Address - Country:US
Practice Address - Phone:978-388-5875
Practice Address - Fax:978-388-6648
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7052103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA155641OtherVALUE OPTIONS
MAW05841OtherBC/BS INDIVIDUAL
MAW50419Medicare ID - Type Unspecified