Stephanie Lyn Concannon, M.ED.

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

255 Highland Ave
Needham, MA 02494-3023

Phone

(781) 449-1884

NPI assigned

Dec 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Stephanie Lyn Regan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Riverside Community Care

  • State or Local Public Health Clinic/Center
  • Needham, MA
  • NPI 1346464823
  NPD (past)
• Riverside Early Intervention

  • Early Intervention Provider Agency
  • Needham Heights, MA
  • NPI 1003241456
  NPD (past)

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1508049065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943023",
            "telephone_number": "781-449-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "STEPHANIE",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "REGAN",
            "middle_name": "LYN",
            "prefix": "MRS.",
            "credential": "M.ED.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Developmental Therapist in Needham, MA
• Providers in Needham, MA by specialty
• Developmental Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.