Provider Demographics
NPI:1063005221
Name:STRZALKA, ALYSSA (LICSW, MT-BC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:STRZALKA
Suffix:
Gender:
Credentials:LICSW, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95061
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02495-0061
Mailing Address - Country:US
Mailing Address - Phone:617-564-3278
Mailing Address - Fax:
Practice Address - Street 1:53 LANGLEY RD STE 380
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1946
Practice Address - Country:US
Practice Address - Phone:617-564-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12123225A00000X
MA1235921041C0700X
PACW0241541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist