Provider Demographics
NPI:1851011027
Name:LINDA J. DUNPHY, MSW, LADC I
Entity Type:Organization
Organization Name:LINDA J. DUNPHY, MSW, LADC I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DUNPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LADC I
Authorized Official - Phone:508-857-9613
Mailing Address - Street 1:140 MOHAWK RD
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-5263
Mailing Address - Country:US
Mailing Address - Phone:085-857-9613
Mailing Address - Fax:
Practice Address - Street 1:152 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2766
Practice Address - Country:US
Practice Address - Phone:508-443-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000123415OtherMASSACHUSETTS BOARD OF REGISTRATION OF SOCIAL WORKERS
MA887OtherTHE BUREAU OF SUBSTANCE ADDICTION SERVICES' (BSAS) ALCOHOL AND DRUG COUNSELOR LI
MA110168231AMedicaid