Provider Demographics
NPI:1326413337
Name:BOBEK, CHARLENE (MED)
Entity type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:
Last Name:BOBEK
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 PLEASANT ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7121
Mailing Address - Country:US
Mailing Address - Phone:978-655-1823
Mailing Address - Fax:
Practice Address - Street 1:232 PLEASANT ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7121
Practice Address - Country:US
Practice Address - Phone:978-655-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209557101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor