Stephanie Ann Backman, LICSW
Individual provider Active NPI Clinical Social Worker · Orleans, MA
NPI 1003981101 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003981101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 105922 (MA)
- Practice address
- 165 RT 6a
Orleans, MA 02653-3267 - Phone
- (508) 255-2322
- Fax
- (508) 255-2399
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105922 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 105922 | MA | Yes |
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
165 RT 6a
Orleans, MA 02653-3267
Mailing address
PO Box 164
Wellfleet, MA 02667-0164
Phone (508) 255-2322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105922 | Other | MA | LICENSEDINDEPCLIN SOCIALW |
Other providers in Orleans, MA
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- Lisa Arnold
- Arthur F. Hannigan DMD PC
- Jennifer Gooch Avery
- Paige Bauer Barrett
- Bass River Eyes Inc
- Bass River Optical, Inc.
- Jessica Sarah Benoit-Bedford
- Ramona Bertrand
All providers in Orleans, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.