Kelly J Abdalla, LCSW
Individual provider Active NPI Clinical Social Worker · Cambridge, MA
NPI 1720859564 · NPPES record last updated Jan 10, 2024
Key facts
- NPI
- 1720859564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 225463 (MA)
- Practice address
- 700 Massachusetts Ave FL 3
Cambridge, MA 02139-3345 - Phone
- (617) 649-8520
- Fax
- (617) 649-8520
- NPI assigned
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225463 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 225463 | MA | Yes |
Addresses
Primary practice location
700 Massachusetts Ave FL 3
Cambridge, MA 02139-3345
Mailing address
700 Massachusetts Ave FL 3
Cambridge, MA 02139-3345
Phone (617) 649-8520
Other providers in Cambridge, MA
- Adanesh Tsehaye Abbay
- Flannery Boardman Abbey
- Louis M Abbey
- Amanda Warren Abbott
- Kelly Abbott
- Rana Abdallah
- Zahra Abdul Ghafoor
- Khaleel Leroy Abdul-Jabbaar
- Lou Emma Abecassis
- Ellen Abele
All providers in Cambridge, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.