Provider Demographics
NPI:1679638035
Name:HAJER, MARILYN BETH (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:BETH
Last Name:HAJER
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 1:28 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6049
Mailing Address - Country:US
Mailing Address - Phone:617-277-9470
Mailing Address - Fax:
Practice Address - Street 1:28 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6049
Practice Address - Country:US
Practice Address - Phone:617-277-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1119081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01712OtherBLUE CROSS BLUE SHIELD
MAP01712OtherBLUE CROSS BLUE SHIELD