Provider Demographics
NPI:1033375951
Name:FURMAN, ALICE F (LICSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:F
Last Name:FURMAN
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 1:820 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4411
Mailing Address - Country:US
Mailing Address - Phone:508-583-9800
Mailing Address - Fax:508-583-9802
Practice Address - Street 1:820 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4411
Practice Address - Country:US
Practice Address - Phone:508-583-9800
Practice Address - Fax:508-583-9802
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1157441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty