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Provider Information for 1730537879


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ANNA MCIVER MSW


Sex: Female

NPI: 1730537879
Last Updated: 2016-05-31
Certification Date:

Details

NameValue
NPI1730537879
Enumeration Date2016-05-31
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 31 LAKE SHORE CT
APT 2
BRIGHTON, MA 02135-6372
United States

Phone: 413-219-9437 | Fax:
 
Primary Practice Address 10I ROESSLER RD
WOBURN, MA 01801-6208
United States

Phone: 781-932-8114 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101Y00000X - Counselor