Provider Demographics
NPI:1477141810
Name:LINCOLN, ELLEN MARGARET (LICSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARGARET
Last Name:LINCOLN
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 1:100 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-1504
Mailing Address - Country:US
Mailing Address - Phone:978-463-5852
Mailing Address - Fax:
Practice Address - Street 1:100 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-1504
Practice Address - Country:US
Practice Address - Phone:978-463-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1026253101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool