Doctor Name: | THERESA A. SICA |
NPI Number: | 1114159217 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 111461 |
Business Practice Address: | 10 New Driftway Suite 105-g Scituate, MA - 020664546 |
Business Phone Number: | 7815615264 |
Business Fax Number: | |
Mailing Address: | 10 New Driftway, Suite 105-g SCITUATE |
State: | MA |
Postal Code: | 020664546 |
Phone Number: | 7815615264 |
Fax Number: | |
NPI Enumeration Date: | 08/23/2009 |
NPI Last Update Date: | 08/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 111461 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |