MEDICARE: FRANCES WITHAM LICSW

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	1041C0700X	Clinical Social Worker	118938	MA

General Provider Information

NPI Number	:	1831586049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES WITHAM LICSW

Provider Business Mailing Address
First Line	:	40 LYNDON RD
Second Line	:
City	:	WRENTHAM
State	:	MA
Zip	:	02093-1155
Country	:	US
Telephone Number	:	508-496-0593
Fax Number	:

Provider Business Practice Location Address
First Line	:	1032 TURNPIKE ST
Second Line	:	SUITE 204
City	:	CANTON
State	:	MA
Zip	:	02021-2865
Country	:	US
Telephone Number	:	339-364-8510
Fax Number	:

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

Provider Enumeration Date	:	04/26/2015
Last Update Date	:	04/26/2015

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Directions to “ FRANCES WITHAM LICSW” Practice Location

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