Healthcare Provider Details

I. General information

NPI: 1588486955
Provider Name (Legal Business Name): ALLISON LIU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD #122
BEDFORD MA
01730
US

IV. Provider business mailing address

200 SPRINGS RD #122
BEDFORD MA
01730
US

V. Phone/Fax

Practice location:
  • Phone: 781-824-6664
  • Fax: 781-538-6303
Mailing address:
  • Phone: 781-824-6664
  • Fax: 781-538-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLICSW1140332
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: