EVELYN DOUGHERTY LICSW NPI 1861539629

NPI Information

NPI: 1861539629
Provider Name: EVELYN DOUGHERTY, LICSW
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
45 DIMOCK ST
ROXBURY, MA
ZIP 02119
Phone: (617) 442-8800
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Evelyn Dougherty, LICSW is an addiction (substance use disorder) counselor in Roxbury, MA. Evelyn Dougherty, LICSW NPI is 1861539629. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

45 DIMOCK ST
ROXBURY, MA
ZIP 02119-208
Phone: (617) 442-8800

The NPI 1861539629 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 2/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	107476	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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