Provider Demographics
NPI:1740722867
Name:STEPHENS, KATE ELIZABETH (LMSW-CC)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:ELIZABETH
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BAYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6134
Mailing Address - Country:US
Mailing Address - Phone:978-828-3373
Mailing Address - Fax:
Practice Address - Street 1:27 BAYWOOD LN
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6134
Practice Address - Country:US
Practice Address - Phone:978-828-3373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC163681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical