Provider Demographics
NPI:1245719913
Name:GOLDZUNG-ECKART, CONSTANCE JEAN (LICSW)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:JEAN
Last Name:GOLDZUNG-ECKART
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 1:20 STRAWSTONE LN
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1133
Mailing Address - Country:US
Mailing Address - Phone:508-285-6338
Mailing Address - Fax:
Practice Address - Street 1:20 STRAWSTONE LN
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1133
Practice Address - Country:US
Practice Address - Phone:508-285-6338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1078171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical