Healthcare Provider Details

I. General information

NPI: 1831052448
Provider Name (Legal Business Name): JONATHAN ABRAMS, LICSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BEACON ST STE 303
BROOKLINE MA
02446-4812
US

IV. Provider business mailing address

1415 BEACON ST STE 303
BROOKLINE MA
02446-4812
US

V. Phone/Fax

Practice location:
  • Phone: 617-447-4093
  • Fax:
Mailing address:
  • Phone: 617-447-4093
  • Fax: 999-999-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN ABRAMS
Title or Position: OWNER
Credential: LICSW
Phone: 617-447-4093