Provider Demographics
NPI:1912992199
Name:DIMSON-DOYLE, ALAN (LICSW)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:DIMSON-DOYLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MECHANIC ST
Mailing Address - Street 2:STE 205
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2073
Mailing Address - Country:US
Mailing Address - Phone:781-784-3709
Mailing Address - Fax:
Practice Address - Street 1:10 POST OFFICE SQ
Practice Address - Street 2:SUITE 2
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1963
Practice Address - Country:US
Practice Address - Phone:781-784-3709
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1118821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA248589OtherCOMPSYCH
MAP08504OtherBLUE CROSS/BLUE SHIELD
MA1854356OtherMASS HEALTH
MA248589OtherCOMPSYCH