Provider Demographics
NPI:1124161823
Name:AREY, DOUGLAS PHILIP (LICSW)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:PHILIP
Last Name:AREY
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 1:128 CONWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2333
Mailing Address - Country:US
Mailing Address - Phone:413-774-7998
Mailing Address - Fax:413-773-7638
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1499
Practice Address - Country:US
Practice Address - Phone:413-586-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1068571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4398Medicare ID - Type Unspecified