Provider Demographics
NPI:1013074087
Name:EGAN, DOROTHY MURPHY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:MURPHY
Last Name:EGAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BALD ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-5001
Mailing Address - Country:US
Mailing Address - Phone:508-655-1397
Mailing Address - Fax:508-473-6644
Practice Address - Street 1:409 FORTUNEBLVD
Practice Address - Street 2:SUITE 101 MILFORD FRANKLINCOUNSELING SERVICES,INC.
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757
Practice Address - Country:US
Practice Address - Phone:508-473-7400
Practice Address - Fax:508-473-6644
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1054881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP05473Medicare ID - Type UnspecifiedMEDICARE