Provider Demographics
NPI:1649573213
Name:WEME, ERIN D (LICSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:D
Last Name:WEME
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:D
Other - Last Name:GARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1120 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4313
Mailing Address - Country:US
Mailing Address - Phone:617-471-8400
Mailing Address - Fax:617-376-8910
Practice Address - Street 1:1120 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4313
Practice Address - Country:US
Practice Address - Phone:617-471-8400
Practice Address - Fax:617-376-8910
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265EMedicaid