Provider Demographics
NPI:1083663462
Name:MAHFUZ, JAMES J (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:MAHFUZ
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-3605
Mailing Address - Country:US
Mailing Address - Phone:617-889-5204
Mailing Address - Fax:617-887-2873
Practice Address - Street 1:161 WINNISIMMET ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2745
Practice Address - Country:US
Practice Address - Phone:617-889-5204
Practice Address - Fax:617-887-2873
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical