Healthcare Provider Details

I. General information

NPI: 1326716184
Provider Name (Legal Business Name): HAIJIA LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 MONTVALE AVE
STONEHAM MA
02180-3623
US

IV. Provider business mailing address

160 ALEWIFE PKWY 1336
CAMBRIDGE MA
02138
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-6086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number225033
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: