Healthcare Provider Details

I. General information

NPI: 1316123532
Provider Name (Legal Business Name): SHARYL LYNN CARRIGAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 07/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 MOUNT AUBURN ST
WATERTOWN MA
02472
US

IV. Provider business mailing address

1143 EAST ST
MANSFIELD MA
02048-3411
US

V. Phone/Fax

Practice location:
  • Phone: 617-972-9400
  • Fax: 888-977-0776
Mailing address:
  • Phone: 508-631-0163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number213195
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114581
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: