Active NPI
Stephanie Joanne Coppolino, LCSW
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1194932889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 213989
- Practice address
- 129 Blackstone River Rd
Worcester, MA 01607-1491 - Phone
- (508) 757-5579
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 213989 | MA | Primary |
Addresses
Primary practice location
129 Blackstone River Rd
Worcester, MA 01607-1491
Mailing address
129 Blackstone River Rd
Worcester, MA 01607-1491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213989 | MA | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194932889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 BLACKSTONE RIVER RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 BLACKSTONE RIVER RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071491",
"telephone_number": "508-757-5579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPOLINO",
"first_name": "STEPHANIE",
"middle_name": "JOANNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "213989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.