Provider Demographics
NPI:1093109118
Name:KERN, SEAN (LICSW)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:KERN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:E BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:781-422-2950
Mailing Address - Fax:781-422-2955
Practice Address - Street 1:362 N BEDFORD ST
Practice Address - Street 2:
Practice Address - City:E BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1148
Practice Address - Country:US
Practice Address - Phone:781-422-2950
Practice Address - Fax:781-422-2955
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1174781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical