Individual
ALISA DELAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
99 DERBY ST STE 200, HINGHAM, MA 02043-4216
(508) 203-1727
Mailing address
PO BOX 835, BROCKTON, MA 02303-0835
(508) 203-1727
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
124902
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124902
LICSW
MA
Enumeration date
06/02/2022
Last updated
10/13/2023
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