Provider Demographics
NPI:1447096698
Name:MCWHORTER, SOPHIA JERAN (LCSW)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:JERAN
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:MCWHORTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:40 SPRING ST STE 215
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3474
Mailing Address - Country:US
Mailing Address - Phone:617-299-9956
Mailing Address - Fax:844-238-9457
Practice Address - Street 1:40 SPRING ST STE 215
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3474
Practice Address - Country:US
Practice Address - Phone:617-299-9956
Practice Address - Fax:844-238-9457
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2307171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical