Provider Demographics
NPI:1295794881
Name:DELONE, DONNA MARIE (LICSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:DELONE
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 1:60 DUDLEY ST
Mailing Address - Street 2:#312
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-3054
Mailing Address - Country:US
Mailing Address - Phone:617-884-6677
Mailing Address - Fax:
Practice Address - Street 1:10 MAPLE ST
Practice Address - Street 2:#204
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2200
Practice Address - Country:US
Practice Address - Phone:978-777-3674
Practice Address - Fax:978-777-9974
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1054571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA03599Medicare ID - Type Unspecified