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General NPI Number Information
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NPI Number | 1053527861
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Entity Type | Organization
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Legal Business Name | PERKINS SCHOOL
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1121 MAIN ST
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City | LANCASTER
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State | MA
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Zip | 01523-2573
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Country | US
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Telephone | 978-365-7376
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Fax | 978-368-8861
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Provider Business Mailing Address
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Address Line | 1121 MAIN ST
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City | LANCASTER
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State | MA
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Zip | 01523-2573
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Country | US
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Telephone | 978-365-7376
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Fax | 978-368-8861
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Authorized Official
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Title or Position | CLINICIAN
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Name | COLLEEN ELLEN MORIARTY
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Credential | LICSW
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Telephone | 978-368-6442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1025878
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License Number State | MA
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