Provider Demographics
NPI:1063836997
Name:CUSHNER, GEOFFREY (MSW)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:CUSHNER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GROVE ST
Mailing Address - Street 2:STE LL11
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2677
Mailing Address - Country:US
Mailing Address - Phone:508-304-7499
Mailing Address - Fax:774-420-7255
Practice Address - Street 1:108 GROVE ST
Practice Address - Street 2:STE LL11
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2677
Practice Address - Country:US
Practice Address - Phone:508-304-7499
Practice Address - Fax:774-420-7255
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical