Provider Demographics
NPI:1184061327
Name:MANCUSO, DAVID (MSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:MANCUSO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FRENCH KING HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2929
Mailing Address - Country:US
Mailing Address - Phone:413-588-8347
Mailing Address - Fax:
Practice Address - Street 1:131 FRENCH KING HIGHWAY
Practice Address - Street 2:WORK
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301
Practice Address - Country:US
Practice Address - Phone:347-949-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical