Provider Demographics
NPI:1285744144
Name:COLGATE, CARA (LICSW)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:COLGATE
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 1:111 N COMMON ST
Mailing Address - Street 2:FAMILY AND CHILDREN'S SERVICE
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4223
Mailing Address - Country:US
Mailing Address - Phone:617-515-8792
Mailing Address - Fax:
Practice Address - Street 1:111 N COMMON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4223
Practice Address - Country:US
Practice Address - Phone:781-598-5517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1134851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical