Provider Demographics
NPI:1316012131
Name:PARE, CATHERINE (LICSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:PARE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SHERRY-PARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:EAST DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02641-0664
Mailing Address - Country:US
Mailing Address - Phone:508-362-3668
Mailing Address - Fax:508-362-3668
Practice Address - Street 1:947 ROUTE 6A
Practice Address - Street 2:CRANBERRY COURT SUITE 2A
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-2171
Practice Address - Country:US
Practice Address - Phone:508-362-3668
Practice Address - Fax:508-362-3668
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW 1018021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1894561OtherMBHP
MA1894561OtherMBHP