Healthcare Provider Details

I. General information

NPI: 1194734178
Provider Name (Legal Business Name): PATRICIA T CARTER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 WATER ST STE 1
WILLIAMSTOWN MA
01267
US

IV. Provider business mailing address

173 WATER ST STE 1
WILLIAMSTOWN MA
01267-2888
US

V. Phone/Fax

Practice location:
  • Phone: 413-458-8582
  • Fax: 413-458-8750
Mailing address:
  • Phone: 413-458-8582
  • Fax: 413-458-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116978
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: