MEDICARE: NICOLE ORMEROD 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	122788	MA

General Provider Information

NPI Number	:	1356644132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ORMEROD LICSW

Provider Business Mailing Address
First Line	:	363 LIBERTY ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-6042
Country	:	US
Telephone Number	:	617-688-3899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 WASHINGTON ST
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-1675
Country	:	US
Telephone Number	:	617-657-4727
Fax Number	:

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

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	06/24/2020

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Directions to “ NICOLE ORMEROD LICSW” Practice Location

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