Provider Demographics
NPI:1144399452
Name:DALLAMORA, THOMAS MATTHEW (MSW ACSW LICSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MATTHEW
Last Name:DALLAMORA
Suffix:
Gender:M
Credentials:MSW ACSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3500
Mailing Address - Country:US
Mailing Address - Phone:508-877-5457
Mailing Address - Fax:
Practice Address - Street 1:675 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-864-8585
Practice Address - Fax:617-864-8586
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1052741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical