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

LicenseStateTypeSpecialty
111341MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

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

Sources for this page

Verify at the official NPI Registry.