Provider Demographics
NPI:1548455421
Name:SACCO, KATHLEEN ANN (LICSW, MSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:SACCO
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 319
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741
Mailing Address - Country:US
Mailing Address - Phone:978-600-8518
Mailing Address - Fax:866-899-7594
Practice Address - Street 1:19 COLSON STREET
Practice Address - Street 2:
Practice Address - City:NORTH BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862
Practice Address - Country:US
Practice Address - Phone:978-600-8518
Practice Address - Fax:866-899-7594
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1115801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical