Provider Demographics
NPI:1508844705
Name:BARRESI, ELLEN M (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:M
Last Name:BARRESI
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4397
Mailing Address - Country:US
Mailing Address - Phone:508-747-2910
Mailing Address - Fax:775-459-1817
Practice Address - Street 1:362 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4397
Practice Address - Country:US
Practice Address - Phone:508-747-2910
Practice Address - Fax:775-459-1817
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1010251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP05113OtherBCBSMA
MAP05113OtherBCBSMA