Styron, Charles Woodrow

Styron, Charles Woodrow is an sole proprietor health care provider with primary practice located at 173 Mount Auburn St , Watertown MA 02472-4005. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Styron, Charles Woodrow can be contacted via phone (617) 489-5848.

Contact Information

Primary practice address
173 Mount Auburn St Watertown MA 02472-4005
Phone: (617) 489-5848
Fax: (617) 489-5848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6388 Massachusetts

Profile Details

NPI number 1366413841
LBN Legal business name Styron, Charles Woodrow
Credentials PSY. D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2006
Last updated Jul 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366413841 NPPES
Massachusetts Other W05271 BLUE CROSS
Massachusetts Other 95899 BLUE CROSS
Massachusetts MEDICAID 0526916 BLUE CROSS
Massachusetts Other 6153012 BLUE CROSS
Massachusetts Other 330623 BLUE CROSS
Massachusetts Other 103012 BLUE CROSS

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