Provider Demographics
NPI:1750429833
Name:HUNT, TERRY (EDD)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:MR
Other - First Name:ROY
Other - Middle Name:A
Other - Last Name:HUNT
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:EDD
Mailing Address - Street 1:214 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1946
Mailing Address - Country:US
Mailing Address - Phone:617-787-3511
Mailing Address - Fax:617-787-5045
Practice Address - Street 1:214 MARKET ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-1946
Practice Address - Country:US
Practice Address - Phone:617-787-3511
Practice Address - Fax:617-787-5045
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50975Medicare ID - Type UnspecifiedPROVIDER NUMBER