Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tegan Mallary Polhamus, LICSW

Individual provider Social Worker · NPI 1063709806

Tegan Mallary Polhamus, LICSW is a Social Worker in Gloucester, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2011.

Licensed in
MA
In the registry since
2011
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

3 Blackburn Ctr
Gloucester, MA 01930
Phone: (978) 283-7793
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 120986 (MA)
Social Worker Taxonomy 104100000X · Licence 221026 (MA)

Record details

NPI number1063709806
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJune 30, 2011
Last updated in NPPESJanuary 30, 2018

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