Healthcare Provider Details

I. General information

NPI: 1528793981
Provider Name (Legal Business Name): MS. CASEY HATHAWAY-PICCOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date: 04/23/2024
Reactivation Date: 08/25/2026

III. Provider practice location address

199 ROSEWOOD DRIVE, SUITE 300
DANVERS MA
01923-1388
US

IV. Provider business mailing address

199 ROSEWOOD DRIVE, SUITE 300
DANVERS MA
01923-1388
US

V. Phone/Fax

Practice location:
  • Phone: 978-494-8163
  • Fax:
Mailing address:
  • Phone: 978-494-8163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: