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General NPI Number Information
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NPI Number | 1164759783
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Entity Type | Individual
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Provider Name | JEFFREY OGLE DUPREY MSW, LICSW, LAC
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Gender | Male
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | HORIZON BUILDING, BUILDING 4L, SUD-C 421 NORTH MAIN STREET
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City | LEEDS
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State | MA
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Zip | 01053-9764
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Country | US
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Telephone | 413-584-4040
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Fax | 413-582-3137
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Provider Business Mailing Address
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Address Line | 18 EVERETT AVE
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City | BELCHERTOWN
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State | MA
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Zip | 01007-9577
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Country | US
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Telephone | 413-636-5027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 259
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117549
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License Number State | MA
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