Healthcare Provider Details

I. General information

NPI: 1487769907
Provider Name (Legal Business Name): ADAM E. THURLOW LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ENDICOTT RD
BOXFORD MA
01921
US

IV. Provider business mailing address

75 SOUTHERN AVE
ESSEX MA
01929-1415
US

V. Phone/Fax

Practice location:
  • Phone: 978-887-2323
  • Fax:
Mailing address:
  • Phone: 978-412-5869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number181110
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: