Healthcare Provider Details

I. General information

NPI: 1447890785
Provider Name (Legal Business Name): JOSEPH PHILIP REARICK LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HERRICK ST
BEVERLY MA
01915-2734
US

IV. Provider business mailing address

44 CHESLEY RD
NEWTON MA
02459-1938
US

V. Phone/Fax

Practice location:
  • Phone: 561-414-5089
  • Fax:
Mailing address:
  • Phone: 561-414-5089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126932
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: