Basic Information
Provider Information
NPI: 1427268788
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENGLISH
FirstName: WILLIAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 687 HIGHLAND AVE
Address2: SUITE 16
City: NEEDHAM
State: MA
PostalCode: 024942232
CountryCode: US
TelephoneNumber: 8004558726
FaxNumber: 8664558839
Practice Location
Address1: 134 MATHEWSON ST
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 029031807
CountryCode: US
TelephoneNumber: 8004558726
FaxNumber: 8664558839
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X1705RIY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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