Healthcare Provider Details

I. General information

NPI: 1760601058
Provider Name (Legal Business Name): NANCY A. HEWITT M.S.W., LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WASHINGTON ST SUITE 322
SALEM MA
01970-3518
US

IV. Provider business mailing address

70 WASHINGTON ST SUITE 322
SALEM MA
01970-3518
US

V. Phone/Fax

Practice location:
  • Phone: 978-741-1167
  • Fax: 781-599-2070
Mailing address:
  • Phone: 978-741-1167
  • Fax: 781-599-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102704
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: