Provider Demographics
NPI:1942338678
Name:DOWDS, MARK W (LICSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:W
Last Name:DOWDS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MEAGHER AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-2754
Mailing Address - Country:US
Mailing Address - Phone:617-696-9788
Mailing Address - Fax:
Practice Address - Street 1:52 MEAGHER AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-2754
Practice Address - Country:US
Practice Address - Phone:617-696-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1019433101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADO P23355Medicare ID - Type UnspecifiedPSYCHOTHERAPY