Provider Demographics
NPI:1821108788
Name:TRAN, DALENA N (LCSW)
Entity Type:Individual
Prefix:
First Name:DALENA
Middle Name:N
Last Name:TRAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DALENA
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:24 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4408
Mailing Address - Country:US
Mailing Address - Phone:508-753-1260
Mailing Address - Fax:508-831-9624
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:200
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2058
Practice Address - Country:US
Practice Address - Phone:508-753-1260
Practice Address - Fax:508-831-9624
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health