Healthcare Provider Details

I. General information

NPI: 1174346449
Provider Name (Legal Business Name): ABIGAIL DOROTHY CATHERINE WARE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 ELM ST APT 3R
WORCESTER MA
01609-1938
US

IV. Provider business mailing address

113 ELM ST APT 3R
WORCESTER MA
01609-1938
US

V. Phone/Fax

Practice location:
  • Phone: 603-860-7712
  • Fax:
Mailing address:
  • Phone: 603-860-7712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW230853
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: