Provider Demographics
NPI:1730662867
Name:STERN, TZE-WAN GIPSY (LICSW)
Entity Type:Individual
Prefix:
First Name:TZE-WAN
Middle Name:GIPSY
Last Name:STERN
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 1:33 PADULA RD
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-3413
Mailing Address - Country:US
Mailing Address - Phone:781-335-3315
Mailing Address - Fax:
Practice Address - Street 1:1515 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7537
Practice Address - Country:US
Practice Address - Phone:781-848-3939
Practice Address - Fax:781-843-8279
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1143031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical