Provider Demographics
NPI:1780183277
Name:STYBEL, LAURENCE JAMES (EDD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:JAMES
Last Name:STYBEL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4205
Mailing Address - Country:US
Mailing Address - Phone:617-594-7627
Mailing Address - Fax:508-655-1754
Practice Address - Street 1:27 BAYFIELD RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-4205
Practice Address - Country:US
Practice Address - Phone:617-594-7627
Practice Address - Fax:508-655-1754
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2338103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty