Stacey Peters, LICSW
Individual provider Active NPI Clinical Social Worker · Hanscom Afb, MA
NPI 1962760736 · NPPES record last updated Oct 19, 2023
Key facts
- NPI
- 1962760736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 111990 (MA)
- Practice address
- 90 Vandenberg Drive
BLDG 1900 MHC
Hanscom Afb, MA 01731 - Phone
- (781) 225-6384
- NPI assigned
- Apr 30, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 111990 | MA | Yes |
Addresses
Primary practice location
90 Vandenberg Drive
BLDG 1900 MHC
Hanscom Afb, MA 01731
Mailing address
90 Vandenberg Drive
BLDG 1900 MHC
Hanscom Afb, MA 01731
Phone (781) 225-6384
Other providers in Hanscom Afb, MA
- Matthew Robert Nicoli
- Mark Stephen Oordt
- Timothy Joseph Pappalardo
- Jonathan Paul Pazienza
- Sokunthea Peou
- Thuc Tran Van Pham
- Daniel E Reiser
- Michael Alan Ripley
- Paul R. Rivest
- Mara Salis
All providers in Hanscom Afb, 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 Oct 19, 2023. 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.