Provider Demographics
NPI:1144779653
Name:DURKIN, NANCY (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:DURKIN
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 1:60 RUMFORD AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2115
Mailing Address - Country:US
Mailing Address - Phone:508-339-6855
Mailing Address - Fax:
Practice Address - Street 1:60 RUMFORD AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-2115
Practice Address - Country:US
Practice Address - Phone:508-339-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1027570104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker