Provider Demographics
NPI:1790882611
Name:MR. JOHN F. DEMURO, LICSW
Entity Type:Organization
Organization Name:MR. JOHN F. DEMURO, LICSW
Other - Org Name:PRIVATE PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARENT, CHILD, AND FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:DEMURO
Authorized Official - Suffix:I
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-651-7033
Mailing Address - Street 1:20 MAIN ST
Mailing Address - Street 2:SUITE 305B
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4525
Mailing Address - Country:US
Mailing Address - Phone:508-651-7033
Mailing Address - Fax:
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:SUITE 305B
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4525
Practice Address - Country:US
Practice Address - Phone:508-651-7033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty