Provider Demographics
NPI:1912175308
Name:BEARDSLEE, BARBARA OBRIEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:OBRIEN
Last Name:BEARDSLEE
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 1:7 CENTRAL STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476
Mailing Address - Country:US
Mailing Address - Phone:781-641-3664
Mailing Address - Fax:617-868-0004
Practice Address - Street 1:7 CENTRAL STREET
Practice Address - Street 2:SUITE 207
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476
Practice Address - Country:US
Practice Address - Phone:781-641-3664
Practice Address - Fax:617-868-0004
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1016271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical