Individual
MICHELLE AXELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADAC
Contact information
Practice address
7 HAVILAND ST, BOSTON, MA 02115-2683
(617) 267-0900
(617) 267-3667
Mailing address
7 HAVILAND ST, BOSTON, MA 02115-2683
(617) 267-0900
(617) 267-3667
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
114202
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303546
—
MA
Enumeration date
11/02/2006
Last updated
12/14/2007
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