Provider Demographics
NPI:1326023250
Name:LEADER-CRAMER, NANCY F (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:F
Last Name:LEADER-CRAMER
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 1:12 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2303
Mailing Address - Country:US
Mailing Address - Phone:781-598-9708
Mailing Address - Fax:781-598-9708
Practice Address - Street 1:1 WIDGER RD
Practice Address - Street 2:SUITE 305
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2146
Practice Address - Country:US
Practice Address - Phone:781-598-9708
Practice Address - Fax:781-598-9708
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1035531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01288Medicare PIN