Individual
JODI L. STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6293
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6293
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD12083
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007058775
MEDICARE ID-TYPE UNSPECIFIED
RI
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
—
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
15-75763
UNITED BEHAVIORAL HEALTH
RI
01
—
31619-4
BLUE CHIP
RI
01
—
413553
BLUE CROSS
RI
05
—
7058775
—
RI
Enumeration date
07/28/2006
Last updated
05/30/2008
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