Karen Puopolo, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Sutton, MA

NPI 1699899591 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1699899591
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
110476 (MA)
Practice address
176 Worcester Providence Tpke
Suite 203
Sutton, MA 01590-1901
Phone
(508) 581-8797
Fax
(508) 581-8796
NPI assigned
Mar 17, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
110476MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110476 MA Yes

Addresses

Primary practice location

176 Worcester Providence Tpke
Suite 203
Sutton, MA 01590-1901

Mailing address

157 Millbury St
Grafton, MA 01519-1017
Phone (508) 839-2249

Other identifiers

IdentifierTypeStateIssuer
P08720OtherMABLUE CROSS BLUE SHIELD
9444147OtherMAPRIVATE HEALTH CARE SYSTE

Other providers in Sutton, MA

All providers in Sutton, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.