Provider Demographics
NPI:1477659480
Name:MILBERG, WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MILBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FAIRHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3424
Mailing Address - Country:US
Mailing Address - Phone:857-364-2946
Mailing Address - Fax:857-364-4454
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:GRECC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-2946
Practice Address - Fax:857-364-4454
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2599103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical