Provider Demographics
NPI:1205085636
Name:SHLANK-BLOOMENTHAL, DORONIT (LICSW)
Entity type:Individual
Prefix:
First Name:DORONIT
Middle Name:
Last Name:SHLANK-BLOOMENTHAL
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 1:234 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 1:21 GEORGE ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2228
Practice Address - Country:US
Practice Address - Phone:978-710-9877
Practice Address - Fax:888-972-2483
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical