Provider Demographics
NPI:1447947015
Name:HOPKINS, MARY ELLEN (LICSW)
Entity type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:HOPKINS
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 1:3 NERSESIAN WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-1561
Mailing Address - Country:US
Mailing Address - Phone:615-943-9355
Mailing Address - Fax:
Practice Address - Street 1:130 DORCHESTER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2642
Practice Address - Country:US
Practice Address - Phone:617-268-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225817-SW-LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical