Provider Demographics
NPI:1265543581
Name:GAROFANO, MARY ELAINE (LICSW ACSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELAINE
Last Name:GAROFANO
Suffix:
Gender:F
Credentials:LICSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH STREET
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY MDC
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-447-2000
Mailing Address - Fax:
Practice Address - Street 1:725 NORTH STREET
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY MDC
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-447-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0152841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical