Provider Demographics
NPI:1437202652
Name:HAWLEY, NANCY MIRIAM (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MIRIAM
Last Name:HAWLEY
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 1:177 PEMBERTON ST
Mailing Address - Street 2:UNIT 18
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2541
Mailing Address - Country:US
Mailing Address - Phone:617-661-6393
Mailing Address - Fax:617-812-0318
Practice Address - Street 1:177 PEMBERTON ST
Practice Address - Street 2:UNIT 18
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2541
Practice Address - Country:US
Practice Address - Phone:617-661-6393
Practice Address - Fax:617-812-0318
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1003941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical