1073659348 NPI number — MRS. SEYREL WILLIAMS L.I.C.S.W.

Table of content: MRS. SEYREL WILLIAMS L.I.C.S.W. (NPI 1073659348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073659348 NPI number — MRS. SEYREL WILLIAMS L.I.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
SEYREL
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.I.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073659348
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1481
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01944-1481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-525-2111
Provider Business Mailing Address Fax Number:
978-526-1284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 DEER COVE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01902-3120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-525-2111
Provider Business Practice Location Address Fax Number:
978-526-1284
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  106864 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com