| Doctor Name: | MRS. JENNIFER LOUISE GUSTAFSON-STEPHENSON |
| NPI Number: | 1407009046 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | 680188687 |
| Business Practice Address: | 60 Main St Machias, ME - 046541129 |
| Business Phone Number: | 2072591645 |
| Business Fax Number: | 2307561953 |
| Mailing Address: | 60 Main St, MACHIAS |
| State: | ME |
| Postal Code: | 046541129 |
| Phone Number: | 2072591645 |
| Fax Number: | 2072591647 |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 11/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 680188687 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |