Provider Demographics
NPI:1982616413
Name:CAREY, PAMELA DIANE (LICSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DIANE
Last Name:CAREY
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 1:82 LITTLE TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2206
Mailing Address - Country:US
Mailing Address - Phone:508-517-3796
Mailing Address - Fax:978-582-7103
Practice Address - Street 1:615 LEOMINSTER RD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-2013
Practice Address - Country:US
Practice Address - Phone:978-582-7103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1115501041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical