Healthcare Provider Details

I. General information

NPI: 1194824011
Provider Name (Legal Business Name): CARL TORRICE LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 AYER RD SUITE #201
HARVARD MA
01451
US

IV. Provider business mailing address

249 AYER RD SUITE #201
HARVARD MA
01451
US

V. Phone/Fax

Practice location:
  • Phone: 978-387-7449
  • Fax: 978-710-3258
Mailing address:
  • Phone: 978-387-7449
  • Fax: 978-710-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1027179
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1027179
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: