Provider Demographics
NPI:1205025061
Name:DAY, DAVID C (LICSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:DAY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:E
Other - Last Name:COLLINS
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 PARK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-2125
Mailing Address - Country:US
Mailing Address - Phone:508-208-4720
Mailing Address - Fax:
Practice Address - Street 1:116 PARK HILL AVE
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-2125
Practice Address - Country:US
Practice Address - Phone:508-208-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical