Provider Demographics
NPI:1427853258
Name:IYER, NIMITA (LCSW)
Entity type:Individual
Prefix:
First Name:NIMITA
Middle Name:
Last Name:IYER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 THE FENWAY BLDG A-275K
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5820
Mailing Address - Country:US
Mailing Address - Phone:781-888-4991
Mailing Address - Fax:
Practice Address - Street 1:300 THE FENWAY BLDG A-275K
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5820
Practice Address - Country:US
Practice Address - Phone:617-521-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2278861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical