| Square Psychiatry | |
|
124 Watertown St Watertown MA 02472-2576 | |
| (617) 926-8200 | |
| Not Available |
| Full Name | Square Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 124 Watertown St, Watertown, Massachusetts |
| Authorized Official Name and Position | Brian Johnson (OWNER) |
| Authorized Official Contact | 6179268300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Square Psychiatry 124 Watertown St Watertown MA 02472-2576 Ph: (617) 926-8200 | Square Psychiatry 124 Watertown St Watertown MA 02472-2576 Ph: (617) 926-8200 |
| NPI Number | 1609997667 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609997667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1023920 (Massachusetts) | Primary |
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 43500 (Massachusetts) | Primary |
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