Healthcare Provider Details

I. General information

NPI: 1619831732
Provider Name (Legal Business Name): HANNAH FIELDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 PROVIDENCE HWY
DEDHAM MA
02026-6815
US

IV. Provider business mailing address

456 PROVIDENCE HWY
DEDHAM MA
02026-6815
US

V. Phone/Fax

Practice location:
  • Phone: 781-234-1610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1142303
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: