Provider Demographics
NPI:1992896096
Name:BLOCK, DENISE S II (LICSW)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:S
Last Name:BLOCK
Suffix:II
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 1:22 MILL ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-646-7370
Mailing Address - Fax:781-646-0965
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:SUITE 405
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-646-7370
Practice Address - Fax:781-646-0965
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1001721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01522OtherBLUE CROSS
MA715057OtherTUFTS HEALTH PLAN
MAP01522OtherBLUE CROSS