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Individual
MS. MARY G STEPHEN
Active
Individual
MS. MARY G STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
004070
CT
1041C0700X
Clinical Social Worker
Primary
1027673
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000025418
BMC HEALTHNET
—
01
—
00419326
CT BEHAV HLTH PARTNERSHIP
—
01
—
00PNA
MBH PARTNERSHIP
—
01
—
140004070CT03
ANTHEM BCBS
CT
01
—
218483
MHN HMC
—
01
—
375424
MAGELLAN BEHAV HEALTH
—
01
—
P07685
BLUE CROSS BLUE SHIELD
MA
01
—
P2111426
OXFORD
—
01
—
P22241
MEDICARE
MA
Enumeration date
10/27/2006
Last updated
07/08/2007
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