Provider Demographics
NPI:1477723039
Name:VINEYARD, HILARY LOWE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:HILARY
Middle Name:LOWE
Last Name:VINEYARD
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 1:73 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1622
Mailing Address - Country:US
Mailing Address - Phone:508-894-8424
Mailing Address - Fax:508-894-8450
Practice Address - Street 1:940 BELMONT ST BLDG 7
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5596
Practice Address - Country:US
Practice Address - Phone:508-894-8424
Practice Address - Fax:508-894-8450
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health