Healthcare Provider Details

I. General information

NPI: 1194469809
Provider Name (Legal Business Name): ERIC SCHNUR LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1094 WORCESTER RD
FRAMINGHAM MA
01702-5255
US

IV. Provider business mailing address

1094 WORCESTER RD
FRAMINGHAM MA
01702-5255
US

V. Phone/Fax

Practice location:
  • Phone: 508-661-2020
  • Fax:
Mailing address:
  • Phone: 508-661-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1120480
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: