Provider Demographics
NPI:1912080458
Name:FEARING, NAOME MAE (MSW)
Entity type:Individual
Prefix:
First Name:NAOME
Middle Name:MAE
Last Name:FEARING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRADY RD
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1702
Mailing Address - Country:US
Mailing Address - Phone:508-366-4164
Mailing Address - Fax:
Practice Address - Street 1:9 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2505
Practice Address - Country:US
Practice Address - Phone:508-753-7140
Practice Address - Fax:508-755-8645
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FEP01518Medicare ID - Type Unspecified