Provider Demographics
NPI:1487625083
Name:DUPLESSIS, DENISE S (MS, PCNS)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:S
Last Name:DUPLESSIS
Suffix:
Gender:F
Credentials:MS, PCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-0040
Mailing Address - Country:US
Mailing Address - Phone:508-909-7799
Mailing Address - Fax:
Practice Address - Street 1:161 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571
Practice Address - Country:US
Practice Address - Phone:508-765-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNCNS21791163WC0400X
RIRN21791163WP0807X
RIPPNS0040364SP0807X
MARN166154364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDD31513Medicaid
RIDD31513Medicaid
S67233Medicare UPIN
RI007009896Medicare UPIN