Provider Demographics
NPI:1932420866
Name:DOBAS, MARY (LMHC, LADC-1)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DOBAS
Suffix:
Gender:F
Credentials:LMHC, LADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2897
Mailing Address - Country:US
Mailing Address - Phone:617-817-1831
Mailing Address - Fax:
Practice Address - Street 1:697 CAMBRIDGE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2897
Practice Address - Country:US
Practice Address - Phone:617-817-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7561101YP2500X
MA2265101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)