| Yvonne Nickerson Licsw Llc | |
|
11 Market St Mashpee MA 02649-7134 | |
| (508) 524-8511 | |
| (508) 433-1871 |
| Full Name | Yvonne Nickerson Licsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11 Market St, Mashpee, Massachusetts |
| Authorized Official Name and Position | Yvonne Cf Nickerson (OWNER) |
| Authorized Official Contact | 5085248511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yvonne Nickerson Licsw Llc Po Box 1192 Mashpee MA 02649-1192 Ph: (508) 524-8511 | Yvonne Nickerson Licsw Llc 11 Market St Mashpee MA 02649-7134 Ph: (508) 524-8511 |
| NPI Number | 1932772340 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 07/22/2021 |
| Certification Date | 07/22/2021 |
| Medicare PECOS PAC ID | 3274909361 |
|---|---|
| Medicare Enrollment ID | O20221013003535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932772340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Yvonne Nickerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275849077 PECOS PAC ID: 2365731320 Enrollment ID: I20181129001142 |
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