Provider Demographics
NPI:1134100860
Name:HUBER, CELESTE DENISE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:DENISE
Last Name:HUBER
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 1:14 SOUTH ST
Mailing Address - Street 2:2ND FLOOR, SUITE 1
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1638
Mailing Address - Country:US
Mailing Address - Phone:508-366-2530
Mailing Address - Fax:508-366-2531
Practice Address - Street 1:14 SOUTH ST
Practice Address - Street 2:2ND FLOOR, SUITE 1
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1638
Practice Address - Country:US
Practice Address - Phone:508-366-2530
Practice Address - Fax:508-366-2531
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10289641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA791237OtherTUFTS PROVIDER NO.
MAA019799OtherVALUE OPTIONS PID#
MA2035372OtherCIGNA PROVIDER ID
MA9094998OtherPHCS PID#
MA341795OtherMAGELLAN PROVIDER #
MAPO7598OtherBCBSMA PROVIDER NUMBER
MA1030060OtherBHS PROVIDER ID
MA341795OtherMAGELLAN PROVIDER #