Provider Demographics
NPI:1780756791
Name:MCDOWELL, THEODORA NOYES (LICSW, PHD)
Entity type:Individual
Prefix:DR
First Name:THEODORA
Middle Name:NOYES
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:LICSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062
Mailing Address - Country:US
Mailing Address - Phone:617-877-7726
Mailing Address - Fax:978-225-2251
Practice Address - Street 1:92 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062
Practice Address - Country:US
Practice Address - Phone:413-533-5201
Practice Address - Fax:413-532-1846
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104545104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker