Provider Demographics
NPI:1285140830
Name:MULCAHEY, ANITA LOUISE (LICSW)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:LOUISE
Last Name:MULCAHEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALDER ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-2268
Mailing Address - Country:US
Mailing Address - Phone:508-533-3803
Mailing Address - Fax:
Practice Address - Street 1:15 ALDER ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-2268
Practice Address - Country:US
Practice Address - Phone:508-533-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10216881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical