Provider Demographics
NPI:1316274855
Name:BLUM, MARIA ALISA (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ALISA
Last Name:BLUM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 NEWTON RD # 2
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-3210
Mailing Address - Country:US
Mailing Address - Phone:617-545-4943
Mailing Address - Fax:
Practice Address - Street 1:12 NEWTON RD # 2
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-3210
Practice Address - Country:US
Practice Address - Phone:617-545-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1239581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty