MEDICARE: MARIA LUIZA JULIET BARBOSA WELTON 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	120571	MA

General Provider Information

NPI Number	:	1902230782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA LUIZA JULIET BARBOSA WELTON LICSW

Provider Business Mailing Address
First Line	:	ONE CONSTITUTION WHARF
Second Line	:	SUITE 140
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-4316
Country	:	US
Telephone Number	:	857-408-3797
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 JUMEL PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-4316
Country	:	US
Telephone Number	:	212-927-6675
Fax Number	:

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

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	02/24/2022

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