Provider Demographics
NPI:1518441732
Name:LATERZ, JEAN (LICSW)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:LATERZ
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 1:44 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-1305
Mailing Address - Country:US
Mailing Address - Phone:508-430-5337
Mailing Address - Fax:
Practice Address - Street 1:44 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-1305
Practice Address - Country:US
Practice Address - Phone:508-430-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10230181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical