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NPI Code Detail

MEDICARE: DELIA MONTAGUE HAGAN LCSW

MEDICARE: DELIA MONTAGUE HAGAN LCSW
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
1101YM0800XMental Health CounselorLCSW221073MA

General Provider Information

NPI Number : 1578414298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELIA MONTAGUE HAGAN LCSW
Provider Business Mailing Address
First Line : 110 BOSTON ST
Second Line :
City : SALEM
State : MA
Zip : 01970-1402
Country : US
Telephone Number : 781-559-4900
Fax Number :
Provider Business Practice Location Address
First Line : 3 BLACKBURN CTR
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-2268
Country : US
Telephone Number : 781-559-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2026
Last Update Date : 02/07/2026

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