Provider Demographics
NPI:1851454961
Name:DUMAS, CORDELIA ANNE (MA MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:CORDELIA
Middle Name:ANNE
Last Name:DUMAS
Suffix:
Gender:F
Credentials:MA MSW LICSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:50 NORTH SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6249
Mailing Address - Country:US
Mailing Address - Phone:508-997-6091
Mailing Address - Fax:508-999-7795
Practice Address - Street 1:50 NORTH SECOND STREET
Practice Address - Street 2:PSYCHIATRIC AND PSYCHOLOGICAL ASSOCIATES
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6249
Practice Address - Country:US
Practice Address - Phone:508-997-6091
Practice Address - Fax:508-999-7795
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111183103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI273541OtherBLUE CROSS BLUE SHIELD
MAP07970OtherBLUE CROSS BLUE SHIELD
235611OtherMANAGED HEALTH NTWK
235611OtherTRICARE NORTH
RI273541OtherBLUE CROSS BLUE SHIELD