Provider Demographics
NPI:1821381559
Name:PRUSZYNSKI, ANN E (LICSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:PRUSZYNSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:E
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:354 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7079
Mailing Address - Country:US
Mailing Address - Phone:508-661-2039
Mailing Address - Fax:508-628-7329
Practice Address - Street 1:354 WAVERLY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-661-2039
Practice Address - Fax:508-628-7329
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1180131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical