Provider Demographics
NPI:1124309554
Name:HAUSERMANN, ABBIE D (LICSW)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:D
Last Name:HAUSERMANN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:DUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:720 HARRISON AVE
Mailing Address - Street 2:DOB 503
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON MEDICAL CTR PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2908
Practice Address - Country:US
Practice Address - Phone:617-414-5245
Practice Address - Fax:617-638-6836
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1177951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical