Provider Demographics
NPI:1700089083
Name:ALIAGA, MARTHA CLARISA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:CLARISA
Last Name:ALIAGA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AMESBURY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1311
Mailing Address - Country:US
Mailing Address - Phone:978-689-5504
Mailing Address - Fax:978-203-6081
Practice Address - Street 1:101 AMESBURY ST STE 205
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1311
Practice Address - Country:US
Practice Address - Phone:978-689-5504
Practice Address - Fax:978-203-6081
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075018AMedicaid