Provider Demographics
NPI:1336296920
Name:DORR, CAROL BARTHOLOMEW (LICSW PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:BARTHOLOMEW
Last Name:DORR
Suffix:
Gender:F
Credentials:LICSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1108
Mailing Address - Country:US
Mailing Address - Phone:978-838-2996
Mailing Address - Fax:978-838-2744
Practice Address - Street 1:76 RANDALL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MA
Practice Address - Zip Code:01503-1108
Practice Address - Country:US
Practice Address - Phone:978-838-2996
Practice Address - Fax:978-838-2744
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105157104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker