Alisa Mary Doherty, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117705 Issued in MA

Practice address

705 Mount Auburn St
Watertown, MA 02472

Phone

(857) 304-8401

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Alisa Mary Graceffa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1902939069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SUMMER ST",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017541056",
            "telephone_number": "978-495-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "857-304-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "ALISA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "CSW7213",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISA",
            "last_name": "GRACEFFA",
            "middle_name": "MARY",
            "credential": "LICSW, LCSW, CMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Dimare
• Carolyn Dinjian, NP
• Hoang-Oanh Thi Doan, DO
• Carolyn M Dobies, NP
• Eliza Ruth Dodge
• Domenic D'Amico, DMD PC
• Danielle Anika Domingue Sumi, MA, MFT
• Edward W Donle, D.M.D.
• Jacqueline Donovan
• Susan Elizabeth Doolittle, L.I.C.S.W.

• Clinical Social Worker in Watertown, MA
• Providers in Watertown, 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 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.