Provider Demographics
NPI:1245549997
Name:FLANAGAN, ALICIA M
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:M
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5465
Mailing Address - Country:US
Mailing Address - Phone:781-891-0556
Mailing Address - Fax:781-647-1432
Practice Address - Street 1:6512 47TH ST
Practice Address - Street 2:
Practice Address - City:RIVERDALE PARK
Practice Address - State:MD
Practice Address - Zip Code:20737-1093
Practice Address - Country:US
Practice Address - Phone:240-653-9100
Practice Address - Fax:240-653-9200
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker