Provider Demographics
NPI:1265743256
Name:WARD, WILLIAM EDWARD JR
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EDWARD
Last Name:WARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KJ
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:93 MASSACHUSETTS AVE
Mailing Address - Street 2:FL. 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1817
Mailing Address - Country:US
Mailing Address - Phone:617-266-3349
Mailing Address - Fax:
Practice Address - Street 1:15 EDISON AVE
Practice Address - Street 2:APT. 1
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5829
Practice Address - Country:US
Practice Address - Phone:781-219-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor