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Organization
SOUTHEAST ADOLESCENT AND ADULT COUNSELING
Active
Organization
SOUTHEAST ADOLESCENT AND ADULT COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYLOU SHEARING LICSW (SOLE MEMBER)
(508) 954-4431
Entity
Organization
Contact information
Practice address
455 W CENTER ST, SUITE 3, WEST BRIDGEWATER, MA 02379-1637
(508) 954-4431
Mailing address
455 W CENTER ST, SUITE 3, WEST BRIDGEWATER, MA 02379-1637
(508) 954-4431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
105297
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007377
HARVARD PILGRIM HEALTHCARE
—
01
—
1005325
FALLON COMMUNITY HEALTH PLAN
—
01
—
109603
BLUE CROSS/ BLUE SHIELD HMO
—
01
—
2078990
CIGNA
—
01
—
453450
TUFTS
—
01
—
P04466
BLUE CROSS/BLUE SHIELD
—
Enumeration date
08/13/2008
Last updated
08/13/2008
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