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NPI Code Detail

MEDICARE: MR. JOHN F. DEMURO, LICSW

MEDICARE: MR. JOHN F. DEMURO, LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist106136MA

General Provider Information

NPI Number : 1790882611
Entity Type Code : Organization
Provider Name (Legal Business Name) : MR. JOHN F. DEMURO, LICSW
Provider Business Mailing Address
First Line : 20 MAIN ST
Second Line : SUITE 305B
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 508-651-7033
Fax Number :
Provider Business Practice Location Address
First Line : 20 MAIN ST
Second Line : SUITE 305B
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 508-651-7033
Fax Number :
Authorized Official
Title or Position : PARENT, CHILD, AND FAMILY THERAPIST
Name : MR. JOHN FRANCIS DEMURO I
Credential : LICSW
Telephone Number : 508-651-7033
Provider Enumeration Date : 09/20/2006
Last Update Date : 08/22/2020

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