Provider Demographics
NPI:1093925406
Name:DEWEY, JOAN P (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:P
Last Name:DEWEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2287
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:AK
Mailing Address - Zip Code:99559-2287
Mailing Address - Country:US
Mailing Address - Phone:907-543-5885
Mailing Address - Fax:907-543-5885
Practice Address - Street 1:#23 TRAILER PARK
Practice Address - Street 2:AIRPORT ROAD
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559-2287
Practice Address - Country:US
Practice Address - Phone:907-543-5885
Practice Address - Fax:907-543-5885
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical