Nickerson, Carol J Sutherland
Nickerson, Carol J Sutherland is an sole proprietor health care provider with primary practice located at 915 Route 28 , Harwich MA 02645-3448. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Nickerson, Carol J Sutherland can be contacted via phone (508) 432-5640.Contact Information
Primary practice address
915 Route 28
Harwich MA 02645-3448
Phone: (508) 432-5640
Fax: (508) 432-5659
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1023047 | Massachusetts |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 1023047 | Massachusetts |
Profile Details
| NPI number | 1548244254 |
|---|---|
| LBN Legal business name | Nickerson, Carol J Sutherland |
| Credentials | LICSW BCD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Feb 3rd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548244254 | NPPES |
| Other | P06795 | BCBS | |
| Other | 1890743 | BCBS | |
| Other | 762332 | BCBS | |
| Other | 184437000 | BCBS |
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