Provider Demographics
NPI:1215008321
Name:HUNTER, SEWARD THOMAS (MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:SEWARD
Middle Name:THOMAS
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-3020
Mailing Address - Country:US
Mailing Address - Phone:617-628-3163
Mailing Address - Fax:617-776-0994
Practice Address - Street 1:1105 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 1G
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5220
Practice Address - Country:US
Practice Address - Phone:617-628-3163
Practice Address - Fax:617-776-0994
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10206991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP08367OtherBLUE CROSS BLUE SHIELD
MA85126Medicaid
MA85126Medicaid