Provider Demographics
NPI:1609305796
Name:FLANAGAN, SIOBHAN (LICSW)
Entity Type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:
Last Name:FLANAGAN
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 1:131 GILSON RD
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4644
Mailing Address - Country:US
Mailing Address - Phone:215-384-3390
Mailing Address - Fax:
Practice Address - Street 1:859 WILLARD ST STE 420
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7469
Practice Address - Country:US
Practice Address - Phone:617-903-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1202521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical