Provider Demographics
NPI:1790771665
Name:DIONNE, JEANNE MARIE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:MARIE
Last Name:DIONNE
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 1:3040 FALMOUTH RD
Mailing Address - Street 2:UNIT J3
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655-1200
Mailing Address - Country:US
Mailing Address - Phone:508-428-3162
Mailing Address - Fax:508-428-3162
Practice Address - Street 1:3040 FALMOUTH RD
Practice Address - Street 2:UNIT J3
Practice Address - City:OSTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02655-1200
Practice Address - Country:US
Practice Address - Phone:508-428-3162
Practice Address - Fax:508-428-3162
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1105021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA02520OtherPACIFICARE
MA352233600OtherMAGELLAN
MA2119663OtherCIGNA
MA1153280OtherBEACON HEALTH STRATEGIES
MA87726OtherUNITEDBEHAVIORALHEALTH
MAP07865OtherBC/BS
MAP07865OtherMEDEX
MAA02520OtherPACIFICARE