Provider Demographics
NPI:1346557071
Name:BAINTON, DEBORAH ELAINE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ELAINE
Last Name:BAINTON
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:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02651-0166
Mailing Address - Country:US
Mailing Address - Phone:508-237-2881
Mailing Address - Fax:
Practice Address - Street 1:820 COUNTY ROAD
Practice Address - Street 2:POCASSET MENTAL HEALTH CENTER
Practice Address - City:POCASSET
Practice Address - State:MA
Practice Address - Zip Code:02559
Practice Address - Country:US
Practice Address - Phone:800-352-7742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10209031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical