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General NPI Number Information
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NPI Number | 1962942706
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Entity Type | Organization
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Legal Business Name | CATHLEEN METZGER
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 165 OLD KINGS HIGHWAY
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City | ORLEANS
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State | MA
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Zip | 02653
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Country | US
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Telephone | 508-221-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 176 BRADFORD ST
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City | PROVINCETOWN
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State | MA
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Zip | 02657-2423
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Country | US
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Telephone | 508-221-6706
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | CATHLEEN METZGER
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Credential | LICSW
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Telephone | 508-221-6706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LICSW 120219
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License Number State | MA
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