Provider Demographics
NPI:1073990792
Name:SAWYER, PAUL JR (LICSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SAWYER
Suffix:JR
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LINCOLN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1561
Mailing Address - Country:US
Mailing Address - Phone:508-404-8467
Mailing Address - Fax:
Practice Address - Street 1:383 ELLIOT ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWTON UPPER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02464-1126
Practice Address - Country:US
Practice Address - Phone:508-404-8467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS69842832101Y00000X
MA1213961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor