MEDICARE: MS. CATHERINE PEARCE CAMPBELL LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1021976	MA

General Provider Information

NPI Number	:	1023183696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE PEARCE CAMPBELL LICSW

Provider Business Mailing Address
First Line	:	288 WEST ST STE 3B
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1234
Country	:	US
Telephone Number	:	508-422-0248
Fax Number	:	508-422-0261

Provider Business Practice Location Address
First Line	:	288 WEST ST STE 3B
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1234
Country	:	US
Telephone Number	:	508-422-0248
Fax Number	:	508-422-0261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	10/08/2021

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Directions to “ MS. CATHERINE PEARCE CAMPBELL LICSW” Practice Location

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