Provider Demographics
NPI:1396228037
Name:DEVEREUX, BARBARA DOLBEARE (LICSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DOLBEARE
Last Name:DEVEREUX
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 1:5 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2821
Mailing Address - Country:US
Mailing Address - Phone:978-979-7702
Mailing Address - Fax:
Practice Address - Street 1:5 CROSS ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2821
Practice Address - Country:US
Practice Address - Phone:978-979-7702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1107371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical