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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

MARY RAY MAZAKA, LICSW
1153 CENTRE ST
2ND FLOOR
BOSTON, MA02130-3446
 Phone: 617-983-7233
 Fax: 617-983-7231
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for MARY RAY MAZAKA · (Female)

NPI Number 1003024597
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 05/18/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • MA License # 104788
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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