Provider Demographics
NPI:1942410592
Name:DU BOIS, CAROLYN S (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:S
Last Name:DU BOIS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MAIN ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3137
Mailing Address - Country:US
Mailing Address - Phone:413-584-2841
Mailing Address - Fax:
Practice Address - Street 1:160 MAIN ST
Practice Address - Street 2:SUITE 16
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3137
Practice Address - Country:US
Practice Address - Phone:413-584-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1004161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical