Provider Demographics
NPI:1275697831
Name:SALEME, MARIA IRMA (LICSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:IRMA
Last Name:SALEME
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:PO BOX 2225
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01903-2225
Mailing Address - Country:US
Mailing Address - Phone:781-595-8080
Mailing Address - Fax:781-595-0128
Practice Address - Street 1:112 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1050
Practice Address - Country:US
Practice Address - Phone:781-595-8080
Practice Address - Fax:781-595-0128
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024868104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO7370OtherBCBS OF MA
MA007205OtherVALUE OPTIONS HPHC
MA1890981Medicaid
MA6219428OtherUBH
MA1890981Medicaid