Provider Demographics
NPI:1356407829
Name:SOMMERS, CHRISTINE (MSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SOMMERS
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 1:5 BELKNAP TER
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1536
Mailing Address - Country:US
Mailing Address - Phone:781-431-7323
Mailing Address - Fax:
Practice Address - Street 1:8 GROVE ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7797
Practice Address - Country:US
Practice Address - Phone:781-431-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03978Medicare ID - Type Unspecified