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General NPI Number Information
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NPI Number | 1255905303
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Entity Type | Individual
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Provider Name | ERIN CLANCY LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 20 CABOT BLVD STE 227
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City | MANSFIELD
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State | MA
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Zip | 02048-1183
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Country | US
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Telephone | 508-589-5333
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Fax | 774-250-2693
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Provider Business Mailing Address
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Address Line | 77 MAIN STREET SECOND FLOOR
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City | HOPKINTON
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State | MA
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Zip | 01748-2463
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Country | US
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Telephone | 774-509-5059
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Fax | 774-250-2693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LICSW128154
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License Number State | MA
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