Provider Demographics
NPI:1730320219
Name:PAYNE-ROKOWSKI, DEANNE MARY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNE
Middle Name:MARY
Last Name:PAYNE-ROKOWSKI
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 1:303 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3925
Mailing Address - Country:US
Mailing Address - Phone:413-540-1100
Mailing Address - Fax:413-534-7158
Practice Address - Street 1:303 BEECH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3925
Practice Address - Country:US
Practice Address - Phone:413-540-1100
Practice Address - Fax:413-534-7158
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1172291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical