Provider Demographics
NPI:1144034877
Name:DEAN, VIOLA (LCSW)
Entity type:Individual
Prefix:
First Name:VIOLA
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 BREMEN ST APT 207
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-5104
Mailing Address - Country:US
Mailing Address - Phone:563-564-5302
Mailing Address - Fax:
Practice Address - Street 1:555 AMORY ST STE 2
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2672
Practice Address - Country:US
Practice Address - Phone:617-457-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2311041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical