Healthcare Provider Details

I. General information

NPI: 1568603454
Provider Name (Legal Business Name): LENKA URBAN MSC., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 LEBANON ST MELROSE WAKEFIELD HOSPITAL - MEDICAL 6
MELROSE MA
02176-3225
US

IV. Provider business mailing address

585 LEBANON ST MELROSE WAKEFIELD HOSPITAL - MEDICAL 6
MELROSE MA
02176-3225
US

V. Phone/Fax

Practice location:
  • Phone: 781-979-3302
  • Fax: 781-979-3496
Mailing address:
  • Phone: 781-979-3302
  • Fax: 781-979-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW 115972
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: