Provider Demographics
NPI:1881711885
Name:KURLAND, MARTHA JENNIFER (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:JENNIFER
Last Name:KURLAND
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 1:33 BEDFORD ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4319
Mailing Address - Country:US
Mailing Address - Phone:781-862-8537
Mailing Address - Fax:781-863-2646
Practice Address - Street 1:33 BEDFORD ST
Practice Address - Street 2:SUITE 20
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4319
Practice Address - Country:US
Practice Address - Phone:781-862-8537
Practice Address - Fax:781-863-2646
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10276071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical