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NPI Code Detail

MEDICARE: LIFE MANAGEMENT ASSOCIATES INC

MEDICARE: LIFE MANAGEMENT ASSOCIATES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2101Y00000XCounselor
3103TA0700XAdult Development & Aging Psychologist
4101YM0800XMental Health Counselor1543MA
5103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1164598199
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE MANAGEMENT ASSOCIATES INC
Provider Business Mailing Address
First Line : PO BOX 904
Second Line :
City : ACTON
State : MA
Zip : 01720-0904
Country : US
Telephone Number : 978-772-4457
Fax Number : 978-772-7107
Provider Business Practice Location Address
First Line : 257 AYER RD
Second Line :
City : HARVARD
State : MA
Zip : 01451-1108
Country : US
Telephone Number : 978-772-4457
Fax Number : 978-772-7107
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN R MICHELSON
Credential : PHD
Telephone Number : 978-772-4457
Provider Enumeration Date : 11/28/2006
Last Update Date : 10/28/2011

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Directions to “LIFE MANAGEMENT ASSOCIATES INC ” Practice Location

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