MEDICARE: MERRILL BETH ADLER LICSW

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
1	1041C0700X	Clinical Social Worker	103560	MA

General Provider Information

NPI Number	:	1760963953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRILL BETH ADLER LICSW

Provider Business Mailing Address
First Line	:	110 STRATHMORE RD APT 304
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-7188
Country	:	US
Telephone Number	:	617-277-6796
Fax Number	:

Provider Business Practice Location Address
First Line	:	475 FRANKLIN ST STE 110
Second Line	:
City	:	FRAMINGHAM
State	:	MA
Zip	:	01702-6265
Country	:	US
Telephone Number	:	508-875-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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Directions to “ MERRILL BETH ADLER LICSW” Practice Location

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