MEDICARE: JEANETTE SILBERSTEIN MACLEAN 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	116107	MA

General Provider Information

NPI Number	:	1548741341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE SILBERSTEIN MACLEAN LICSW

Provider Business Mailing Address
First Line	:	36 POWDER HOUSE BLVD
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1306
Country	:	US
Telephone Number	:	781-883-0567
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 POWDER HOUSE BLVD
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1306
Country	:	US
Telephone Number	:	781-883-0567
Fax Number	:

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

Provider Enumeration Date	:	08/28/2018
Last Update Date	:	08/28/2018

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Directions to “ JEANETTE SILBERSTEIN MACLEAN LICSW” Practice Location

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