Provider Demographics
NPI:1407190069
Name:FELDMAN, MASHA (LICSW)
Entity type:Individual
Prefix:MRS
First Name:MASHA
Middle Name:
Last Name:FELDMAN
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 1:37 HATHERLY RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4616
Mailing Address - Country:US
Mailing Address - Phone:617-590-1770
Mailing Address - Fax:
Practice Address - Street 1:37 HATHERLY RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-4616
Practice Address - Country:US
Practice Address - Phone:617-590-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1193011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical