Provider Demographics
NPI:1770015026
Name:DUDIK JONES, LINORE MARY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LINORE
Middle Name:MARY
Last Name:DUDIK JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:LINORE
Other - Middle Name:MARY
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:27 PARK ST
Mailing Address - Street 2:DEPARTMENT OF CASE MANAGEMENT CAPE COD HOSPITAL
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5230
Mailing Address - Country:US
Mailing Address - Phone:508-862-5501
Mailing Address - Fax:508-862-7937
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:DEPARTMENT OF CASE MANAGEMENT CAPE COD HOSPITAL
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5230
Practice Address - Country:US
Practice Address - Phone:508-862-5501
Practice Address - Fax:508-862-7937
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1178881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical