Constance B Ahlstrom, LICSW
Individual provider Active NPI Clinical Social Worker · Watertown, MA
NPI 1992010243 · NPPES record last updated Aug 11, 2010
Key facts
- NPI
- 1992010243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 111341 (MA)
- Practice address
- 22 Mount Auburn St
Watertown, MA 02472-3992 - Phone
- (617) 489-5052
- NPI assigned
- Aug 11, 2010
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111341 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 111341 | MA | Yes |
Addresses
Primary practice location
22 Mount Auburn St
Watertown, MA 02472-3992
Mailing address
24 Edward St
Belmont, MA 02478-2343
Phone (617) 489-5052
Other providers in Watertown, MA
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- Barry Joseph Agranat
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- Edward Sherwin M Aguilar
- Diane Ah-Kine NG Poon Hing
- Aid Mass LLC
- Aida M Yavshayan, MD
- Christine Aigamaua
- Maryam Akbari
- Varteni Tina Akian
All providers in Watertown, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.