Provider Demographics
NPI:1922426170
Name:SOCKOL, VIVIAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:SOCKOL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 POND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3822
Mailing Address - Country:US
Mailing Address - Phone:508-528-6037
Mailing Address - Fax:508-520-6783
Practice Address - Street 1:38 POND ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3807
Practice Address - Country:US
Practice Address - Phone:508-528-6037
Practice Address - Fax:508-520-6783
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6467103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist