Individual
CAROL SUE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
77 WARREN ST, BUILDING 2, BRIGHTON, MA 02135-3601
(617) 787-4662
(617) 787-4662
Mailing address
77 WARREN ST, BUILDING 2 3RD FLOOR, BRIGHTON, MA 02135-3601
(617) 787-4662
(617) 787-4662
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
105567
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008625
PACIFICARE
MA
01
—
147511000
HMO/MAGELLAN
MA
01
—
602105
TUFTS
MA
01
—
P06741
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/25/2006
Last updated
05/20/2009
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