Provider Demographics
NPI:1073660130
Name:WESTCOTT, ANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:WESTCOTT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 MAIN ST STE 9
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3058
Mailing Address - Country:US
Mailing Address - Phone:978-254-7875
Mailing Address - Fax:978-405-5056
Practice Address - Street 1:1150 MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3058
Practice Address - Country:US
Practice Address - Phone:978-287-5057
Practice Address - Fax:978-405-5056
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10194981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWEP22442Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID