Provider Demographics
NPI:1134282569
Name:MICHAEL, HELEN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4602
Mailing Address - Country:US
Mailing Address - Phone:617-969-6283
Mailing Address - Fax:617-277-0312
Practice Address - Street 1:1581 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4602
Practice Address - Country:US
Practice Address - Phone:617-964-8991
Practice Address - Fax:617-277-0312
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1051851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07678OtherBLUE CROSS BLUE SHIELD
MAP22093Medicare ID - Type Unspecified