Provider Demographics
NPI:1740371897
Name:NEIDICH, CATHY A (MSW)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:A
Last Name:NEIDICH
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 1:9 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1519
Mailing Address - Country:US
Mailing Address - Phone:508-655-0173
Mailing Address - Fax:
Practice Address - Street 1:9 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHERBORN
Practice Address - State:MA
Practice Address - Zip Code:01770-1519
Practice Address - Country:US
Practice Address - Phone:508-655-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106019-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical