Stephanie Ann Backman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105922 Issued in MA

Practice address

165 RT 6a
Orleans, MA 02653-3267

Phone

(508) 255-2322

Fax

(508) 255-2399

NPI assigned

Nov 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003981101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 164",
            "city": "WELLFLEET",
            "state": "MA",
            "postal_code": "026670164",
            "telephone_number": "508-255-2322",
            "fax_number": "508-255-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 RT 6A",
            "city": "ORLEANS",
            "state": "MA",
            "postal_code": "026533267",
            "telephone_number": "508-255-2322",
            "fax_number": "508-255-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKMAN",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105922",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSEDINDEPCLIN SOCIALW",
            "identifier": "105922",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Orleans, MA
• Providers in Orleans, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.