Provider Demographics
NPI:1548329428
Name:DOLAWAY, DEBORAH ANN (LICSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:DOLAWAY
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 1:5 HEATHER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2614
Mailing Address - Country:US
Mailing Address - Phone:508-830-2414
Mailing Address - Fax:508-830-2399
Practice Address - Street 1:7 S SPOONER ST
Practice Address - Street 2:ISIS PSYCHOTHERAPY
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4446
Practice Address - Country:US
Practice Address - Phone:508-830-2414
Practice Address - Fax:508-830-2399
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1070031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP05914OtherBLUE CROSS BLUE SHIELD