Provider Demographics
NPI:1760550917
Name:WEBBER, DOROTHY A (MSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:A
Last Name:WEBBER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:A
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:76 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420
Mailing Address - Country:US
Mailing Address - Phone:978-343-2433
Mailing Address - Fax:978-343-0791
Practice Address - Street 1:76 SUMMER ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-343-2433
Practice Address - Fax:978-343-0791
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1308785Medicaid
MA690527OtherTUFTS
MA1306421Medicaid
MA1308785Medicaid