Tage Lilja Licsw LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TAGE LILJA LICSW LLC

Practice address

7 Harris Ave Ste 1B
Boston, MA 02130-2888

Phone

(802) 391-9865

NPI assigned

Aug 3, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tage Lilja, LICSWNPI 1780827147

Title

Sole Member

Phone

(802) 556-2257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tage Alan Lilja, MSW, LICSW

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1780827147

  MA

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1205500329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300138",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021300002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HARRIS AVE STE 1B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021302888",
            "telephone_number": "802-391-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAGE LILJA LICSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "LILJA",
        "authorized_official_first_name": "TAGE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "802-556-2257",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas M Tadros, M.D.
• Mark Fahim Tadrosse, DMD
• Leah Taffel, MD
• Casey Tyler Taft, PH.D.
• Katherine Taft, NP
• Michelle Tagerman, PT
• Samantha Tagerman, DMD
• Alphonse G Taghian, MD
• Nadine Taghian
• Amir H Taghinia, M.D.

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.