Provider Demographics
NPI:1477640936
Name:DIMOCK CLARK, MAUREEN ELIZABETH (MSW, LICSW)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:DIMOCK CLARK
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:ELIZABETH
Other - Last Name:DIMOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:27 GOLDEN DR
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2565
Mailing Address - Country:US
Mailing Address - Phone:413-200-7437
Mailing Address - Fax:
Practice Address - Street 1:27 GOLDEN DR
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2565
Practice Address - Country:US
Practice Address - Phone:413-200-7437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1154341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical