Individual
MRS. DIANE WINTHROP HAWKINS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISCW
Contact information
Practice address
30 GREEN ST, NEWBURYPORT, MA 01950
(978) 462-5646
Mailing address
NEWBURYPORT COUNSELING GROUP 30 GREEN ST, NEWBURYPORT, MA 01950
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106112
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
338623
MAGELLAN
—
01
—
P05239
BCBS
—
Enumeration date
10/12/2006
Last updated
07/08/2007
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