Provider Demographics
NPI:1093740755
Name:HART, WILLIAM D (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:HART
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 METACOM AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-5119
Mailing Address - Country:US
Mailing Address - Phone:401-254-8447
Mailing Address - Fax:401-254-2076
Practice Address - Street 1:480 METACOM AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-5119
Practice Address - Country:US
Practice Address - Phone:401-254-8447
Practice Address - Fax:401-254-2076
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1065181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical