Provider Demographics
NPI:1447298153
Name:DAWBER, WILLIAM CLARK (LICSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CLARK
Last Name:DAWBER
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 1:15 CEDAR CREST LN
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4501
Mailing Address - Country:US
Mailing Address - Phone:781-545-5264
Mailing Address - Fax:720-834-0617
Practice Address - Street 1:15 CEDAR CREST LN
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4501
Practice Address - Country:US
Practice Address - Phone:781-545-5264
Practice Address - Fax:720-834-0617
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW 100181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health