Provider Demographics
NPI:1942954862
Name:DORONIT S. BLOOMENTHAL, LICSW, LLC
Entity Type:Organization
Organization Name:DORONIT S. BLOOMENTHAL, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DORONIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHLANK-BLOOMENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-467-4423
Mailing Address - Street 1:234 LITTLETON RD STE 1D
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3530
Mailing Address - Country:US
Mailing Address - Phone:978-467-4423
Mailing Address - Fax:
Practice Address - Street 1:234 LITTLETON RD STE 1D
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3530
Practice Address - Country:US
Practice Address - Phone:978-467-4423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty