Provider Demographics
NPI:1548489776
Name:HEALEY, GREG (LICSW)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:HEALEY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ESSEX CENTER DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2910
Mailing Address - Country:US
Mailing Address - Phone:978-532-7588
Mailing Address - Fax:978-532-2494
Practice Address - Street 1:6 ESSEX CENTER DR
Practice Address - Street 2:SUITE 107
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2910
Practice Address - Country:US
Practice Address - Phone:978-532-7588
Practice Address - Fax:978-532-2494
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10238801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical