Individual
BETH A MANHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
11 CAPE DR, STE 19, MASHPEE, MA 02649-3085
(508) 540-2353
Mailing address
11 CAPE DRIVE, ST 19, MASHPEE, MA 02649
(508) 477-7726
(508) 477-7366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111917
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P08545
BCBS PROVIDER#
MA
Enumeration date
08/09/2006
Last updated
03/29/2019
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