Provider Demographics
NPI:1275265068
Name:ARMY, MIKAELA KIMBERLY (MSW)
Entity Type:Individual
Prefix:MISS
First Name:MIKAELA
Middle Name:KIMBERLY
Last Name:ARMY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5707
Mailing Address - Country:US
Mailing Address - Phone:603-686-1811
Mailing Address - Fax:
Practice Address - Street 1:13 PELHAM RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5707
Practice Address - Country:US
Practice Address - Phone:603-686-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty