Provider Demographics
NPI:1073831137
Name:TANGARONE, LOURDES C (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:C
Last Name:TANGARONE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LOURDES
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:28 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2015
Mailing Address - Country:US
Mailing Address - Phone:603-548-8377
Mailing Address - Fax:
Practice Address - Street 1:10 PHOENIX ROW
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-5734
Practice Address - Country:US
Practice Address - Phone:603-548-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW 1019339-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical