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Individual

MS. DEBORAH FAITH MENDLESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW LICSW

Contact information

Practice address
19 FRONT ST, STE 204, SALEM, MA 01970-3795
(978) 239-4563
Mailing address
4C RUSSELL DR, SALEM, MA 01970
(978) 239-4563

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1029208
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107561
UBH
01
248108000
HARVARD PILGRIM
01
P07737
BCBS
Enumeration date
09/27/2006
Last updated
08/05/2021
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