Healthcare Provider Details

I. General information

NPI: 1093640732
Provider Name (Legal Business Name): AMINA AWAD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 HUNTINGTON AVE FL 14
BOSTON MA
02115-3134
US

IV. Provider business mailing address

154 CEDAR ST
SOMERVILLE MA
02144-2665
US

V. Phone/Fax

Practice location:
  • Phone: 888-572-0795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2120308
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: