Provider Demographics
NPI:1407927288
Name:DEJONGE-LEE, CAREN (MSW, LICSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:CAREN
Middle Name:
Last Name:DEJONGE-LEE
Suffix:
Gender:F
Credentials:MSW, LICSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1145
Mailing Address - Country:US
Mailing Address - Phone:508-541-6051
Mailing Address - Fax:
Practice Address - Street 1:15 SHORT ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1145
Practice Address - Country:US
Practice Address - Phone:508-541-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1079881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical