Provider Demographics
NPI:1972784924
Name:THURLOW, THERESA JAQUAY (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:JAQUAY
Last Name:THURLOW
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CEDAR ST STE 212
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1831
Mailing Address - Country:US
Mailing Address - Phone:978-701-1565
Mailing Address - Fax:
Practice Address - Street 1:14 CEDAR ST STE 212
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-1831
Practice Address - Country:US
Practice Address - Phone:978-701-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1224701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical