Provider Demographics
NPI:1710626643
Name:REBECCA S GAFFRON MSW
Entity Type:Organization
Organization Name:REBECCA S GAFFRON MSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GAFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:860-808-6241
Mailing Address - Street 1:12 DEPONTE DR
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1538
Mailing Address - Country:US
Mailing Address - Phone:860-808-6241
Mailing Address - Fax:
Practice Address - Street 1:12 DEPONTE DR
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1538
Practice Address - Country:US
Practice Address - Phone:860-808-6241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health