Provider Demographics
NPI:1831586049
Name:WITHAM, FRANCES (LICSW)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:WITHAM
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 1:40 LYNDON RD
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1155
Mailing Address - Country:US
Mailing Address - Phone:508-496-0593
Mailing Address - Fax:
Practice Address - Street 1:1032 TURNPIKE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2865
Practice Address - Country:US
Practice Address - Phone:339-364-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-26
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1189381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical