Provider Demographics
NPI:1013238500
Name:ROUGHTON, ANNE E (LICSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:ROUGHTON
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 1:181 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1346
Mailing Address - Country:US
Mailing Address - Phone:413-387-7767
Mailing Address - Fax:
Practice Address - Street 1:60 MAPLE ST
Practice Address - Street 2:STE 2B
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1293
Practice Address - Country:US
Practice Address - Phone:413-387-7767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1157741041C0700X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)