Provider Demographics
NPI:1831280502
Name:MANDEL, FRANCIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:FRANCIE
Middle Name:
Last Name:MANDEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 WASHINGTON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3511
Mailing Address - Country:US
Mailing Address - Phone:617-787-4662
Mailing Address - Fax:617-787-4662
Practice Address - Street 1:280 WASHINGTON ST
Practice Address - Street 2:SUITE 305
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3511
Practice Address - Country:US
Practice Address - Phone:617-787-4662
Practice Address - Fax:617-787-4662
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA602105OtherTUFTS HEALTH PLAN
MAPO4520Medicare ID - Type Unspecified