Active NPI
Willene Stevenson, LMT
- Massage Therapist
- Watertown, NY
National Provider Identifier
1588321160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 029852
- Practice address
- 405 Gaffney Dr Apt 1
Watertown, NY 13601-1867 - Phone
- (718) 915-4443
- NPI assigned
- Nov 18, 2021
- Last updated
- Nov 18, 2021
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 029852 | NY | Primary |
Addresses
Primary practice location
405 Gaffney Dr Apt 1
Watertown, NY 13601-1867
Mailing address
405 Gaffney Dr Apt 1
Watertown, NY 13601-1867
Phone (718) 915-4443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029852 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1588321160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 GAFFNEY DR APT 1",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011867",
"telephone_number": "718-915-4443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 GAFFNEY DR APT 1",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011867",
"telephone_number": "718-915-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "WILLENE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-18",
"last_updated": "2021-11-18",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "029852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.