MEDICARE: C. W. DEAN TSAPATSARIS 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
1	1041C0700X	Clinical Social Worker	105447	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	715303	OTHER	MA	TUFTS HEALTH PLAN
2	016976	OTHER	MA	HARVARD PILGRIM
3	69186	OTHER	MA	CIGNA BEHAVIORAL HEALTH
4	011488	OTHER	MA	VALUEOPTIONS
5	052643000	OTHER	MA	MAGELLAN BEHAVIORAL HEALT
6	P04879	OTHER	MA	BLUE CROSS OF MA

General Provider Information

NPI Number	:	1073615522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	C. W. DEAN TSAPATSARIS LICSW

Provider Business Mailing Address
First Line	:	435 NEWBURY ST
Second Line	:	SUITE 220
City	:	DANVERS
State	:	MA
Zip	:	01923-1065
Country	:	US
Telephone Number	:	978-777-7188
Fax Number	:	978-774-1283

Provider Business Practice Location Address
First Line	:	435 NEWBURY ST
Second Line	:	SUITE 220
City	:	DANVERS
State	:	MA
Zip	:	01923-1065
Country	:	US
Telephone Number	:	978-777-7188
Fax Number	:	978-774-1283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	07/08/2007

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Directions to “ C. W. DEAN TSAPATSARIS LICSW” Practice Location

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