Provider Demographics
NPI:1881769925
Name:FLAHERTY, CHRISTINE (LICSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:FLAHERTY
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 1:10 LAFAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-255-1270
Mailing Address - Fax:978-255-1158
Practice Address - Street 1:10 LAFAYETTE STREET
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950
Practice Address - Country:US
Practice Address - Phone:978-255-1270
Practice Address - Fax:978-255-1158
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10157301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA171220OtherMAGELLAN
MA717529OtherTUFTS
MAP04844Medicare ID - Type Unspecified