Provider Demographics
NPI:1679918569
Name:CARR, JOHN CHIRSTOPHER (LICSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHIRSTOPHER
Last Name:CARR
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 1:1492 HIGHLAND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2606
Mailing Address - Country:US
Mailing Address - Phone:646-263-6032
Mailing Address - Fax:
Practice Address - Street 1:1492 HIGHLAND AVE STE 5
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2606
Practice Address - Country:US
Practice Address - Phone:646-263-6032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1180431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical