Provider Demographics
NPI:1013377381
Name:DUVAL, DOROTHY (LICSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:DUVAL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 S UNION ST
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2837
Mailing Address - Country:US
Mailing Address - Phone:978-687-5858
Mailing Address - Fax:978-687-5857
Practice Address - Street 1:439 S UNION ST
Practice Address - Street 2:SUITE 203B
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-687-5852
Practice Address - Fax:978-687-5857
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1014081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical