Provider Demographics
NPI:1164635660
Name:CHADWICK, PATRICIA ELLEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:CHADWICK
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 DOCK LN
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2613
Mailing Address - Country:US
Mailing Address - Phone:978-270-2297
Mailing Address - Fax:978-463-3155
Practice Address - Street 1:1 MERRIMAC ST STE 16
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2562
Practice Address - Country:US
Practice Address - Phone:978-270-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10206831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARE4234Medicare ID - Type UnspecifiedCLINICAL SOCIAL W