Provider Demographics
NPI:1407391642
Name:MORES, REBECCA (LICSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MORES
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:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-0404
Mailing Address - Country:US
Mailing Address - Phone:508-333-7818
Mailing Address - Fax:
Practice Address - Street 1:145 CABOT ST
Practice Address - Street 2:#4
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5109
Practice Address - Country:US
Practice Address - Phone:508-333-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-26
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1163161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical