MEDICARE: WILLEEN CAPEHART LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	223461	MA
2	1041C0700X	Clinical Social Worker	223461	MA

General Provider Information

NPI Number	:	1184103657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLEEN CAPEHART LCSW

Provider Business Mailing Address
First Line	:	391 VARNUM AVE
Second Line	:
City	:	LOWELL
State	:	MA
Zip	:	01854-2119
Country	:	US
Telephone Number	:	401-598-7414
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 NATE WHIPPLE HWY STE 202
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-1423
Country	:	US
Telephone Number	:	401-405-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	02/15/2025

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Directions to “ WILLEEN CAPEHART LCSW” Practice Location

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