Provider Demographics
NPI:1548007081
Name:LESSING, MADELINE AZZI (LICSW)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:AZZI
Last Name:LESSING
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 1:2 LEE HILL RD APT 12
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1739
Mailing Address - Country:US
Mailing Address - Phone:401-588-1525
Mailing Address - Fax:
Practice Address - Street 1:2 LEE HILL RD APT 12
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-1739
Practice Address - Country:US
Practice Address - Phone:401-588-1525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1283111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical