MEDICARE: DR. CARLA NAUMBURG 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	113319	MA

General Provider Information

NPI Number	:	1932644192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLA NAUMBURG LICSW

Provider Business Mailing Address
First Line	:	22 ABERDEEN ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02461-1802
Country	:	US
Telephone Number	:	617-454-4732
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 AUSTIN ST
Second Line	:	SUITE 210
City	:	NEWTON
State	:	MA
Zip	:	02460-1857
Country	:	US
Telephone Number	:	617-454-4732
Fax Number	:

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

Provider Enumeration Date	:	12/27/2016
Last Update Date	:	12/27/2016

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