Provider Demographics
NPI:1346388733
Name:REUBINS, STEPHANIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:REUBINS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 POWERS RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1028
Mailing Address - Country:US
Mailing Address - Phone:978-808-4117
Mailing Address - Fax:
Practice Address - Street 1:319 LITTLETON RD
Practice Address - Street 2:SUITE 102 BOX 103
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4126
Practice Address - Country:US
Practice Address - Phone:978-692-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1050521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO3187OtherBLUE CROSS NUMBER