Provider Demographics
NPI:1376789776
Name:LAZARUS, HARRIET J (MSW)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:J
Last Name:LAZARUS
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 1:53 SAINT PAUL ST
Mailing Address - Street 2:UNIT #2
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6501
Mailing Address - Country:US
Mailing Address - Phone:617-549-2416
Mailing Address - Fax:781-693-1167
Practice Address - Street 1:1 BROOKLINE PLACE
Practice Address - Street 2:SUITE 426
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-731-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1004431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALAPO1082OtherBLUE CROSS BLUE SHIELD
MA1376789776OtherSCO