Provider Demographics
NPI:1164904744
Name:TREFRY, DEANA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:TREFRY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:587 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1531
Mailing Address - Country:US
Mailing Address - Phone:978-998-1523
Mailing Address - Fax:
Practice Address - Street 1:255 GRAPEVINE RD
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01984
Practice Address - Country:US
Practice Address - Phone:978-867-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1107301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical