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Provider Information for 1740777044


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Mrs. HOLLY GERETY LICSW


Sex: Female

NPI: 1740777044
Last Updated: 2025-02-06
Certification Date: 2025-02-06

Details

NameValue
NPI1740777044
Enumeration Date2018-04-23
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 80 LEARNING LN
PEMBROKE, MA 02359-3321
United States

Phone: 617-821-6116 | Fax:
 
Primary Practice Address 80 LEARNING LN
PEMBROKE, MA 02359-3321
United States

Phone: 781-293-4023 | Fax:
 
Secondary Practice Address(es)

6 TROUT BROOK TRL
KINGSTON, MA 02364-1887
United States

Phone: 781-293-4023 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 1041S0200X - Social Worker - SchoolMA110452
Yes 1041C0700X - Social Worker - ClinicalMA110452