=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588486955
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON LIU LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2024
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 SPRINGS RD #122
-----------------------------------------------------
City | BEDFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-824-6664
-----------------------------------------------------
Fax | 781-538-6303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 SPRINGS RD #122
-----------------------------------------------------
City | BEDFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-824-6664
-----------------------------------------------------
Fax | 781-538-6303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | LICSW1140332
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------