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General NPI Number Information
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NPI Number | 1437536166
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Entity Type | Individual
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Provider Name | MICHAEL NICHOLAS MSW
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Gender | Male
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 406 MASSACHUSETTS AVE
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City | ARLINGTON
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State | MA
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Zip | 02474-6700
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Country | US
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Telephone | 617-489-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 35 FREMONT ST APT B-6
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City | ARLINGTON
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State | MA
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Zip | 02474-3652
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Country | US
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Telephone | 603-770-3752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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