| Stephanie Ault, | |
| 
					86 Baker Avenue Ext Ste 100, Concord, MA 01742-2132  | |
| (978) 369-1113 | |
| (978) 369-0908 | 
| Full Name | Stephanie Ault | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Mental Health | 
| Location | 86 Baker Avenue Ext Ste 100, Concord, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710501028 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary | 
| Entity Name | Eliot Community Human Services | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1679648182 PECOS PAC ID: 2062488000 Enrollment ID: O20040909001199  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Stephanie Ault, 125 Hartwell Ave, Lexington, MA 02421-3100 Ph: (781) 861-0890  | Stephanie Ault, 86 Baker Avenue Ext Ste 100, Concord, MA 01742-2132 Ph: (978) 369-1113  | 
Judith Glixon, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Mr. Jeff C Desjarlais,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 185 Main St, Concord, MA 01742 Phone: 978-402-2336  | |
Constance Dimarino, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113  | |
Mr. Christopher Hardiman, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Nicole Sheehan,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 86 Baker Avenue Ext Ste 100, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Kristen Kenney,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 236 Partridge Ln, Concord, MA 01742 Phone: 617-763-7200  | |
Gabrielle Kosta,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 86 Baker Avenue Ext Ste 100, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  |