Provider Demographics
NPI:1871902510
Name:KASRAWI, DENISE (LICSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:KASRAWI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:DOUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3206
Mailing Address - Country:US
Mailing Address - Phone:617-541-1895
Mailing Address - Fax:
Practice Address - Street 1:115 WARREN ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-3206
Practice Address - Country:US
Practice Address - Phone:617-541-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114721104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker