Healthcare Provider Details

I. General information

NPI: 1104035401
Provider Name (Legal Business Name): CLEARVIEW CENTER OF NEW ENGLAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PONDVIEW PLACE
TYNGSBORO MA
01879
US

IV. Provider business mailing address

6 PONDVIEW PLACE
TYNGSBORO MA
01879
US

V. Phone/Fax

Practice location:
  • Phone: 978-649-9980
  • Fax: 978-649-9127
Mailing address:
  • Phone: 978-649-9980
  • Fax: 978-649-9127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number614
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106234
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number678
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number614
License Number StateMA

VIII. Authorized Official

Name: MS. KATHRYN ANNE CHAPMAN
Title or Position: DIRECTOR
Credential: MSW LICSW
Phone: 978-649-9980