Provider Demographics
NPI:1558496331
Name:MORGAN, WILLIAM D (PSYD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MAYHEW ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125
Mailing Address - Country:US
Mailing Address - Phone:617-282-1228
Mailing Address - Fax:
Practice Address - Street 1:6 BIGELOW ST
Practice Address - Street 2:BIGELOW HEALING ARTS
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-288-9721
Practice Address - Fax:617-576-7435
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6219103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04959OtherBLUE CROSS BLUE SHIELD
MAM0W04959Medicare ID - Type Unspecified