Provider Demographics
NPI:1023708328
Name:UWAKWE, KATHLEEN (LICSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:UWAKWE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BOSTON TPKE STE 31401545
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3446
Mailing Address - Country:US
Mailing Address - Phone:978-999-2165
Mailing Address - Fax:
Practice Address - Street 1:415 BOSTON TPKE STE 314
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3476
Practice Address - Country:US
Practice Address - Phone:978-999-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226801104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker