Provider Demographics
NPI:1629169875
Name:MCCABE, PATRICK (LICSW)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MCCABE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DEMARCO RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2019
Mailing Address - Country:US
Mailing Address - Phone:401-359-0234
Mailing Address - Fax:
Practice Address - Street 1:50 LEXINGTON ST # 2
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8219
Practice Address - Country:US
Practice Address - Phone:401-359-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW017431041C0700X
MA1145521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI31107-8OtherBLUE CROSS