Provider Demographics
NPI:1043212145
Name:GLEASON, PAULINE FRANCES (MSW)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:FRANCES
Last Name:GLEASON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:PAULINE
Other - Middle Name:FRANCES
Other - Last Name:LUKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 SPEEN ST
Mailing Address - Street 2:STE 105
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-1898
Mailing Address - Country:US
Mailing Address - Phone:508-620-1655
Mailing Address - Fax:509-620-0418
Practice Address - Street 1:40 SPEEN ST
Practice Address - Street 2:STE 105
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-1898
Practice Address - Country:US
Practice Address - Phone:508-620-1655
Practice Address - Fax:509-620-0418
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1053891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA461001OtherTUFTS HEALTH PLAN
MAPO3475Medicare UPIN
MA461001OtherTUFTS HEALTH PLAN