Provider Demographics
NPI:1356325534
Name:DEMBY, ANNETTE HELENE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:HELENE
Last Name:DEMBY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:HELENE
Other - Last Name:ALOVIS BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 SPALDING ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3233
Mailing Address - Country:US
Mailing Address - Phone:617-524-1333
Mailing Address - Fax:617-522-2126
Practice Address - Street 1:15 SPALDING ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3233
Practice Address - Country:US
Practice Address - Phone:617-524-1333
Practice Address - Fax:617-522-2126
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1047131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4436Medicare ID - Type Unspecified