Massong, Stefan
Massong, Stefan is an individual health care provider with primary practice located at 2472 Pass Rd , Biloxi MS 39531-2838. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Massong, Stefan can be contacted via phone (228) 388-9303.Contact Information
Primary practice address
2472 Pass Rd
Biloxi MS 39531-2838
Phone: (228) 388-9303
Fax: (228) 388-9306
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 35-579 | Mississippi |
Profile Details
| NPI number | 1568556082 |
|---|---|
| LBN Legal business name | Massong, Stefan |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568556082 | NPPES |
| Mississippi | Other | 11428838W | CAQH |
| Mississippi | MEDICAID | 00121755 | CAQH |
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