Provider Demographics
NPI:1780864710
Name:FLAGG, ANN M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:FLAGG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3248
Mailing Address - Country:US
Mailing Address - Phone:978-745-2440
Mailing Address - Fax:978-745-7615
Practice Address - Street 1:162 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3248
Practice Address - Country:US
Practice Address - Phone:978-745-2440
Practice Address - Fax:978-745-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214638101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor