Provider Demographics
NPI:1710042528
Name:WECHSLER, BETH (MSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2422
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-8422
Mailing Address - Country:US
Mailing Address - Phone:508-477-0007
Mailing Address - Fax:508-477-0007
Practice Address - Street 1:18 STEEPLE ST.
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-8422
Practice Address - Country:US
Practice Address - Phone:508-477-0007
Practice Address - Fax:508-477-0007
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1040911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical