Provider Demographics
NPI:1902994726
Name:PARKER, DAWN (LICSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:PARKER
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 1:227 SUMMER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2320
Mailing Address - Country:US
Mailing Address - Phone:617-827-7734
Mailing Address - Fax:
Practice Address - Street 1:2000 MASSACHUSETTS AVE STE 4
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2100
Practice Address - Country:US
Practice Address - Phone:617-827-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1133651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical