Provider Demographics
NPI:1952465023
Name:ZAWACKI, MARY G (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:G
Last Name:ZAWACKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:GOGUEN
Other - Last Name:HUSSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969
Mailing Address - Country:US
Mailing Address - Phone:978-948-7537
Mailing Address - Fax:
Practice Address - Street 1:111 MIDDLETON RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-739-7694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1017533104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker