Doctor Name: | STACEY PETERS |
NPI Number: | 1962760736 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 111990 |
Business Practice Address: | 73 Princeton St Suite 203 N Chelmsford, MA - 018631558 |
Business Phone Number: | 9788973280 |
Business Fax Number: | 9782566579 |
Mailing Address: | 73 Princeton St, Suite 203 N CHELMSFORD |
State: | MA |
Postal Code: | 018631558 |
Phone Number: | 9788973280 |
Fax Number: | 9782566579 |
NPI Enumeration Date: | 04/30/2012 |
NPI Last Update Date: | 04/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 111990 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |