Healthcare Provider Details

I. General information

NPI: 1952321911
Provider Name (Legal Business Name): CATHERINE JEAN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE R LIBERTI LICSW

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 SUMMER ST
HAVERHILL MA
01830-5814
US

IV. Provider business mailing address

9 SCOTT FIELD
ROWLEY MA
01969
US

V. Phone/Fax

Practice location:
  • Phone: 978-373-8222
  • Fax: 979-373-8223
Mailing address:
  • Phone: 978-948-2183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1026430
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: