Provider Demographics
NPI:1790674448
Name:BATARSEH, MARA
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:BATARSEH
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-5613
Mailing Address - Country:US
Mailing Address - Phone:617-784-7649
Mailing Address - Fax:
Practice Address - Street 1:440 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2649
Practice Address - Country:US
Practice Address - Phone:617-299-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health