Provider Demographics
NPI:1346988797
Name:ALTFELD, SAMUEL (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:ALTFELD
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:MR
Other - First Name:SAMUEL
Other - Middle Name:
Other - Last Name:ALTFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:4 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1302
Mailing Address - Country:US
Mailing Address - Phone:617-771-2112
Mailing Address - Fax:
Practice Address - Street 1:4 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1302
Practice Address - Country:US
Practice Address - Phone:617-771-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical