Healthcare Provider Details

I. General information

NPI: 1568782571
Provider Name (Legal Business Name): ANNE THOMAS PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 PARKER ST STE 306
MAYNARD MA
01754-2180
US

IV. Provider business mailing address

141 PARKER ST STE 306
MAYNARD MA
01754-2180
US

V. Phone/Fax

Practice location:
  • Phone: 781-269-1043
  • Fax:
Mailing address:
  • Phone: 781-269-1043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW118395
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: