Provider Demographics
NPI:1841324910
Name:DALEY, JANINE L (LICSW)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:L
Last Name:DALEY
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 1:150 MARKET ST
Mailing Address - Street 2:2ND FLR CENTRAL SQUARE THERAPY ASSOCIATES
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901
Mailing Address - Country:US
Mailing Address - Phone:781-592-6100
Mailing Address - Fax:
Practice Address - Street 1:150 MARKET ST
Practice Address - Street 2:2ND FLR
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901
Practice Address - Country:US
Practice Address - Phone:781-592-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10269501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1028620OtherNHP
395667OtherMAGELLAN
MAP07273OtherBCBS
MA1860071Medicaid
MA1860071Medicaid