Provider Demographics
NPI:1780101428
Name:BIANCHINI, STEPHANIE PAMELA (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:PAMELA
Last Name:BIANCHINI
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 1:59 INDIAN WIND DR
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3025
Mailing Address - Country:US
Mailing Address - Phone:339-236-1104
Mailing Address - Fax:
Practice Address - Street 1:1100 WASHINGTON ST STE 8
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1662
Practice Address - Country:US
Practice Address - Phone:215-792-4138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1253711041C0700X
PACW0217001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HPP735994-02OtherUNITED HEALTH CARE