Provider Demographics
NPI:1194864827
Name:HEWITT, KAREN M (BA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:HEWITT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1906
Mailing Address - Country:US
Mailing Address - Phone:508-854-3320
Mailing Address - Fax:508-753-5051
Practice Address - Street 1:214 HOWARD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8311
Practice Address - Country:US
Practice Address - Phone:508-875-5801
Practice Address - Fax:508-873-8934
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18684OtherBCBS MENTAL HEALTH
MA2220002001OtherBCBS SUBSTANCE ABUSE
MA1306421Medicaid
MA1308785Medicaid
MA2220002001OtherBCBS SUBSTANCE ABUSE