Constance B Ahlstrom, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111341 Issued in MA

Practice address

22 Mount Auburn St
Watertown, MA 02472-3992

Phone

(617) 489-5052

NPI assigned

Aug 11, 2010

Last updated

Aug 11, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1992010243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 EDWARD ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782343",
            "telephone_number": "617-489-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024723992",
            "telephone_number": "617-489-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLSTROM",
        "first_name": "CONSTANCE",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Watertown, MA
• Providers in Watertown, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.