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364 Harvard St Brookline MA 02446-2920 | |
| (617) 277-3490 | |
| (617) 738-2934 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 364 Harvard St, Brookline, Massachusetts |
| Authorized Official Name and Position | Jack Golden (PRESIDENT) |
| Authorized Official Contact | 6172773490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
79 Stedman St Suite 2 Brookline MA 02446-6008 Ph: (617) 277-3490 | 364 Harvard St Brookline MA 02446-2920 Ph: (617) 277-3490 |
| NPI Number | 1740342674 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740342674 | NPI | - | NPPES |
| P10386 | Other | MA | BC-BS GROUP NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 100190 (Massachusetts) | Primary |
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