MEDICARE: TRICIA LYN WELLS 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	1027789	MA

General Provider Information

NPI Number	:	1730195363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRICIA LYN WELLS LICSW

Provider Business Mailing Address
First Line	:	238 MAIN ST
Second Line	:
City	:	GREENFIELD
State	:	MA
Zip	:	01301-3243
Country	:	US
Telephone Number	:	413-774-6252
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 MAIN ST
Second Line	:
City	:	GREENFIELD
State	:	MA
Zip	:	01301-3243
Country	:	US
Telephone Number	:	413-774-6252
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	02/10/2009

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