Provider Demographics
NPI:1063403954
Name:DOLAN, BARBARA A (LICSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:DOLAN
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 1:75 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-9147
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:
Practice Address - Street 1:5 TARKILN RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-1250
Practice Address - Country:US
Practice Address - Phone:781-585-2200
Practice Address - Fax:781-585-1784
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105413104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042297845OtherGIC UNICARE
MA042297845OtherPRIVATE HEALTHCARE SYSTEM
MA409555OtherTUFTS MEDICARE PREFERRED
MA042297845OtherHCVM
MA2590284OtherAETNA
MA1005715OtherNHP
MA2040553OtherCIGNA
MA042297845OtherUNITED HEALTH CARE
MA042297845OtherGREAT WEST HEALTH CARE
MA409555OtherTUFTS
MAA006219OtherHARVARD PILGRIM
MA042297845OtherDOC FIRST
MA042297845OtherTRICARE
MAP03691OtherBCBS
MA2040553OtherCIGNA