Provider Demographics
NPI:1407390891
Name:MAYOCK, STEPHEN PHILIP JR (MA)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PHILIP
Last Name:MAYOCK
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WASHINGTON ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4729
Mailing Address - Country:US
Mailing Address - Phone:781-312-8598
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST
Practice Address - Street 2:SUITE 106
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4729
Practice Address - Country:US
Practice Address - Phone:781-312-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor