Individual
MS. COURTNEY PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 EAST MAIN STREET SUITE 2, GEORGETOWN, MA 01833
(617) 823-5512
Mailing address
1 EAST MAIN STREET SUITE 2, GEORGETOWN, MA 01833
(617) 823-5512
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
116695
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031830
BMC
MA
01
—
1031830
AETNA
MD
01
—
1518164508
MBHP
MA
01
—
1861636193
TEAMSTERS
MD
01
—
963959-01
NETWORD
MA
Enumeration date
04/30/2009
Last updated
03/16/2021
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