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NPI Code Detail

MEDICARE: ALICIA D ELNAGGER

MEDICARE: ALICIA D ELNAGGER
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
1101Y00000XCounselor
21041C0700XClinical Social Worker
3222Q00000XDevelopmental Therapist219966MA
4222Q00000XDevelopmental Therapist
51041C0700XClinical Social Worker2120656MA

General Provider Information

NPI Number : 1679854566
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA D ELNAGGER
Provider Business Mailing Address
First Line : 2 CRESTWOOD LN
Second Line :
City : PEABODY
State : MA
Zip : 01960-3904
Country : US
Telephone Number : 978-818-3709
Fax Number :
Provider Business Practice Location Address
First Line : 500 CUMMINGS CTR STE 3570
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6535
Country : US
Telephone Number : 781-593-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 02/10/2025

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1881432235 — MS. ZOLA LYNN MELVILLE
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Directions to “ ALICIA D ELNAGGER ” Practice Location

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