Provider Demographics
NPI:1720145261
Name:SERRAZINA, MARIA ASSELIN (MA, MSW,LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ASSELIN
Last Name:SERRAZINA
Suffix:
Gender:F
Credentials:MA, MSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SALLI CIR
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-3232
Mailing Address - Country:US
Mailing Address - Phone:413-589-7660
Mailing Address - Fax:
Practice Address - Street 1:52 CHARLTON ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1910
Practice Address - Country:US
Practice Address - Phone:508-765-9101
Practice Address - Fax:508-764-4389
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA1168351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor