Provider Demographics
NPI:1588749865
Name:CHERCHIA, MARGARET BRACKEN (LICSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:BRACKEN
Last Name:CHERCHIA
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 1:89 MAIN ST
Mailing Address - Street 2:STE 407
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2628
Mailing Address - Country:US
Mailing Address - Phone:508-473-4984
Mailing Address - Fax:508-482-7316
Practice Address - Street 1:89 MAIN ST
Practice Address - Street 2:STE 407
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2628
Practice Address - Country:US
Practice Address - Phone:508-473-4984
Practice Address - Fax:508-482-7316
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01472Medicare ID - Type Unspecified