Basic Information
| Provider Information | |||||||||
| NPI: | 1386166320 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JEAN-BASKIN | ||||||||
| FirstName: | STEFFIE | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 NE BRAILLE PL | ||||||||
| Address2: | |||||||||
| City: | JENSEN BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349575345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723200770 | ||||||||
| FaxNumber: | 7723200181 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 NE BRAILLE PL | ||||||||
| Address2: | |||||||||
| City: | JENSEN BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349575345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723200770 | ||||||||
| FaxNumber: | 7723200181 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.