Provider Demographics
NPI:1265526792
Name:WASHBURN, CATHERINE CARLETON (LICSW)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:CARLETON
Last Name:WASHBURN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:KATE
Other - Middle Name:C
Other - Last Name:WASHBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:3036 WEATHERBY CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-7483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:266 FIRST PARISH ROAD
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066
Practice Address - Country:US
Practice Address - Phone:781-545-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10166341041C0700X
NCC0120631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP04804Medicare ID - Type UnspecifiedBCBS; MEDICARE