Provider Demographics
NPI:1861769937
Name:POMFRET, DAWN (LICSW)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:POMFRET
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 1:531 FAUNCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1242
Mailing Address - Country:US
Mailing Address - Phone:508-996-9331
Mailing Address - Fax:
Practice Address - Street 1:531 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1242
Practice Address - Country:US
Practice Address - Phone:508-996-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2020-01-16
Deactivation Date:2011-08-23
Deactivation Code:
Reactivation Date:2011-11-17
Provider Licenses
StateLicense IDTaxonomies
MA1134491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical