Provider Demographics
NPI:1992288526
Name:LARRABEE, MARTHA ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:LARRABEE
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 1:275 HARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1650
Mailing Address - Country:US
Mailing Address - Phone:978-852-8023
Mailing Address - Fax:
Practice Address - Street 1:275 HARWOOD AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1650
Practice Address - Country:US
Practice Address - Phone:978-852-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106787104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker