Active NPIIndividual providerSole proprietor

Bonnie Nessanbaum, LICSW

Social Worker, Clinical in Tewksbury, Massachusetts

NPI Number1669452462
Practice location
1565 Main St, Bld.2 Room 206, Tewksbury, MA 01876-2085
Fax
617-288-3910
Last updated
December 3, 2009

Bonnie Nessanbaum is a Social Worker, Clinical based in Tewksbury, MA. Bonnie Nessanbaum practices in Tewksbury, MA and has the professional credentials of LICSW. The NPI Number for Bonnie Nessanbaum is 1669452462 and holds a License No. 1016620 (MA). The current practice location address for Bonnie Nessanbaum is 1565 Main St, Bld.2 Room 206, Tewksbury, MA 01876-2085 and can be reached out via phone at 617-628-3555 and via fax at 617-288-3910.

Provider Profile Details

NPI Number
1669452462
Provider Name
Bonnie Nessanbaum
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
1565 Main St, Bld.2 Room 206, Tewksbury, MA 01876-2085
Phone Number
617-628-3555
Fax Number
617-288-3910
Primary Taxonomy
Social Worker, Clinical · 1041C0700X
Sole Proprietor
Yes
Provider Enumeration Date
January 18, 2006
Last Update Date
December 3, 2009
NPI Status
Active

Provider Business Practice Location Address Details

Address
1565 Main St
Bld.2 Room 206
Tewksbury, MA 01876-2085
Zip
01876-2085
Phone Number
617-628-3555
Fax Number
617-288-3910
Tewksbury, MA 01876Get directions →

Provider Business Mailing Address Details

Address
38 Pickney St
Somerville, MA 02145
City
Somerville
State
MA
Zip
02145
Phone Number
617-628-3555

License Information

License Number
1016620
License State
MA
Taxonomy
Social Worker, Clinical · 1041C0700X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Bonnie Nessanbaum, LICSW?

The NPI number of Bonnie Nessanbaum, LICSW is 1669452462. It was assigned on January 18, 2006 and is currently active in the NPPES registry.

What is the specialty of Bonnie Nessanbaum, LICSW?

Bonnie Nessanbaum, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in MA under license number 1016620.

Where does Bonnie Nessanbaum, LICSW practice?

The practice location is 1565 Main St, Bld.2 Room 206, Tewksbury, MA 01876-2085. The office can be reached at 617-628-3555 (phone) or 617-288-3910 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1669452462 directly on the NPPES registry website.

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