Provider Demographics
NPI:1871686972
Name:SPOERLE, CAROL A (MSW,LICSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:SPOERLE
Suffix:
Gender:F
Credentials:MSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BROAD REACH
Mailing Address - Street 2:UNIT 610
Mailing Address - City:N WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-2256
Mailing Address - Country:US
Mailing Address - Phone:978-762-7450
Mailing Address - Fax:
Practice Address - Street 1:7 FEDERAL ST
Practice Address - Street 2:STE 35
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3620
Practice Address - Country:US
Practice Address - Phone:978-762-7450
Practice Address - Fax:978-762-7450
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1015881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP-P02724OtherBLUE CROSS BLUE SHIELD