Provider Demographics
NPI:1669583878
Name:DOLVEN, JOHN A (MSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:DOLVEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
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Mailing Address - Street 1:39 MAIN ST
Mailing Address - Street 2:SUITE 33
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3132
Mailing Address - Country:US
Mailing Address - Phone:413-586-3733
Mailing Address - Fax:413-268-3665
Practice Address - Street 1:39 MAIN ST
Practice Address - Street 2:SUITE 33
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3132
Practice Address - Country:US
Practice Address - Phone:413-586-3733
Practice Address - Fax:413-268-3665
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MALICSW1009231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA100923OtherTUFTS HEALTH PLAN
MA8781-01OtherPACIFICARE
MAPO1319OtherBLUECROSSBLUESHIELD
MA1073930000OtherMAGELLANBEHAVIORALHEALTH
MA58349OtherCIGNA
MAPO1319OtherBLUECROSSBLUESHIELD