Provider Demographics
NPI:1245396878
Name:DUNLEA, ROBIN L (LICSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:DUNLEA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:435 NEWBURY STREET
Mailing Address - Street 2:SUITE 214
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1065
Mailing Address - Country:US
Mailing Address - Phone:978-777-3227
Mailing Address - Fax:978-777-3228
Practice Address - Street 1:484 LOWELL ST
Practice Address - Street 2:SUITE 1B-1
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7934
Practice Address - Country:US
Practice Address - Phone:978-536-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10319041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA013129OtherHARVARD PILGRIM
MA1853007Medicaid
MAP07869OtherBCBS
MA460234OtherTUFTS
MA475453000OtherMAGELLAN
MA2074602OtherCIGNA