Provider Demographics
NPI:1073047783
Name:MCGRATH, AUDREY DAVIS (LICSW)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:DAVIS
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 NANCY AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3332
Mailing Address - Country:US
Mailing Address - Phone:978-973-8134
Mailing Address - Fax:
Practice Address - Street 1:440 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2649
Practice Address - Country:US
Practice Address - Phone:720-464-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC237191041C0700X
MA1258191041C0700X
COCSW.099288231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical