Provider Demographics
NPI:1538670831
Name:CISLER, LAURA MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:CISLER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CHILD ST APT 1202
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1785
Mailing Address - Country:US
Mailing Address - Phone:219-871-2037
Mailing Address - Fax:
Practice Address - Street 1:70 EVERETT AVE STE 515
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2363
Practice Address - Country:US
Practice Address - Phone:617-466-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002230901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical