Provider Demographics
NPI:1023682689
Name:STEGNER, THERESA MARIE (MS)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:STEGNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2847
Mailing Address - Country:US
Mailing Address - Phone:978-401-1808
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 307E
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6107
Practice Address - Country:US
Practice Address - Phone:978-922-2280
Practice Address - Fax:978-927-1758
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty