Healthcare Provider Details

I. General information

NPI: 1134100860
Provider Name (Legal Business Name): CELESTE DENISE HUBER L.I.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SOUTH ST 2ND FLOOR, SUITE 1
WESTBOROUGH MA
01581-1638
US

IV. Provider business mailing address

14 SOUTH ST 2ND FLOOR, SUITE 1
WESTBOROUGH MA
01581-1638
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-2530
  • Fax: 508-366-2531
Mailing address:
  • Phone: 508-366-2530
  • Fax: 508-366-2531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1028964
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: