Provider Demographics
NPI:1720219579
Name:CHAREST, STEFFANY LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:STEFFANY
Middle Name:LYNN
Last Name:CHAREST
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 1:129 KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3258
Mailing Address - Country:US
Mailing Address - Phone:413-584-6855
Mailing Address - Fax:
Practice Address - Street 1:50 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3909
Practice Address - Country:US
Practice Address - Phone:413-584-6855
Practice Address - Fax:413-585-1355
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212212104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker