Provider Demographics
NPI:1215412010
Name:AYER, LINDA (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:AYER
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 1:135 BEAVER ST UNIT 111
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8412
Mailing Address - Country:US
Mailing Address - Phone:781-642-0331
Mailing Address - Fax:781-642-0332
Practice Address - Street 1:135 BEAVER ST UNIT 111
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-8412
Practice Address - Country:US
Practice Address - Phone:781-642-0331
Practice Address - Fax:781-642-0332
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1144921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA114492OtherDPL-BOARD OF SOCIAL WORKERS