Provider Demographics
NPI:1093855744
Name:SEWARD, GREGORY (LADC-I, LSW)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:SEWARD
Suffix:
Gender:M
Credentials:LADC-I, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:UMASS MEMORIAL MEDICAL GROUP, INC.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:279 LINCOLN ST
Practice Address - Street 2:AMBULATORY PSYCHIATRY SERVICE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2120
Practice Address - Country:US
Practice Address - Phone:774-443-0376
Practice Address - Fax:508-856-6426
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)