Provider Demographics
NPI:1457869745
Name:BLEICHER, COURTNEY ANN ROTOLO (LICSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANN ROTOLO
Last Name:BLEICHER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ANN
Other - Last Name:BLEICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:25 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3125
Mailing Address - Country:US
Mailing Address - Phone:732-757-1320
Mailing Address - Fax:
Practice Address - Street 1:25 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3125
Practice Address - Country:US
Practice Address - Phone:732-757-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-20
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1201171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical