Provider Demographics
NPI:1659110344
Name:TESORERO, STEPHANIE M (LMHC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:TESORERO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3467
Mailing Address - Country:US
Mailing Address - Phone:508-626-9144
Mailing Address - Fax:
Practice Address - Street 1:25 ELM ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3467
Practice Address - Country:US
Practice Address - Phone:508-784-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health