Provider Demographics
NPI:1588932214
Name:DAUER, GARY (LICSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:DAUER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 MARTELLO RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-2957
Mailing Address - Country:US
Mailing Address - Phone:508-541-7862
Mailing Address - Fax:
Practice Address - Street 1:486 MARTELLO RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2957
Practice Address - Country:US
Practice Address - Phone:508-541-7862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1060341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical