Provider Demographics
NPI:1740216977
Name:HARE, WILLIAM B (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:HARE
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 1:34 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3846
Mailing Address - Country:US
Mailing Address - Phone:617-797-0703
Mailing Address - Fax:978-741-0311
Practice Address - Street 1:ROSEWOOD NURSING AND REHABILITAION CENTER
Practice Address - Street 2:22 JOHNSON ST
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2311
Practice Address - Country:US
Practice Address - Phone:978-535-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7314103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6100109OtherEVERCARE
MA526258Medicaid
MAW05652OtherBCBS MA
MAW05652OtherBCBS MA