Lynn Botsaris, LICSW

Individual provider Active NPI Clinical Social Worker · Boylston, MA

NPI 1427397017 · NPPES record last updated Feb 3, 2013

Key facts

NPI
1427397017
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
110040 (MA)
Practice address
107 Stiles Rd
Boylston, MA 01505-1548
Phone
(774) 364-1880
NPI assigned
Feb 3, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110040 MA Yes

Addresses

Primary practice location

107 Stiles Rd
Boylston, MA 01505-1548

Mailing address

107 Stiles Rd
Boylston, MA 01505-1548
Phone (774) 364-1880

Other providers in Boylston, MA

All providers in Boylston, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.