Provider Demographics
NPI:1326325390
Name:MEAD, MICHELLE A (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:A
Last Name:MEAD
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 1:220 OLD COMMON RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-2208
Mailing Address - Country:US
Mailing Address - Phone:978-365-2803
Mailing Address - Fax:
Practice Address - Street 1:220 OLD COMMON RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-2208
Practice Address - Country:US
Practice Address - Phone:978-365-2803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker