Provider Demographics
NPI:1851457014
Name:PARSON, MICHAEL STEVEN (LICSW, MSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:PARSON
Suffix:
Gender:M
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 PARKER HILL AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-3669
Mailing Address - Country:US
Mailing Address - Phone:617-723-7651
Mailing Address - Fax:
Practice Address - Street 1:260 PARKER HILL AVE APT 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120-3669
Practice Address - Country:US
Practice Address - Phone:617-723-7651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1054771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851411Medicaid
MA1851411Medicaid