Provider Demographics
NPI:1689716136
Name:CARON SIMMERS, GUILLEMETTE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:GUILLEMETTE
Middle Name:
Last Name:CARON SIMMERS
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 1:8 ALPINE STREET
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-6811
Mailing Address - Country:US
Mailing Address - Phone:617-354-5337
Mailing Address - Fax:617-864-8970
Practice Address - Street 1:8 ALPINE STREET
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-6811
Practice Address - Country:US
Practice Address - Phone:617-354-5337
Practice Address - Fax:617-864-8970
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1045331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP02722OtherBCBSMA
MAP02722OtherBCBSMA