Healthcare Provider Details

I. General information

NPI: 1760570113
Provider Name (Legal Business Name): JAMES CAREW M.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WEST STREET C/O MOORE FREE LIBRARY
NEWFANE VT
05345
US

IV. Provider business mailing address

PO BOX 316
NEWFANE VT
05345-0316
US

V. Phone/Fax

Practice location:
  • Phone: 802-365-4468
  • Fax: 802-254-2025
Mailing address:
  • Phone: 802-365-4468
  • Fax: 802-254-2025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089-0000861
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: