DR. CHARLES WOODROW STYRON JR. (NPI# 1366413841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366413841 |
| Entity Type | Individual |
| Full Name | DR. CHARLES WOODROW STYRON JR. |
| Credential | PSY. D. |
| Practice Address |
173 Mount Auburn St Watertown MA 02472-4005 |
| Mailing Address |
35 Waverley St Belmont MA 02478-1958 |
| Practice Telephone | 6174895848 |
| Practice Fax Number | 6174895848 |
| Mailing Telephone | 6174895848 |
| Mailing Fax Number | 6174895848 |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2010-07-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6388 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | UNITED BEHAVIORAL HEALTH | 6153012 | 01 |
| MA | BLUE CROSS | W05271 | 01 |
| MA | CIGNA | 103012 | 01 |
| MA | 0526916 | 05 | |
| MA | HARVARD PILGRIM HEALTH CA | 330623 | 01 |
| MA | MANAGED HEALTH CARE | 95899 | 01 |
| Street Address |
173 MOUNT AUBURN ST |
| City | WATERTOWN |
| State | MA |
| Zip Code | 02472-4005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245866318 | Morgan Sutherland | Massage Therapist | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2020-03-20 |
| 1447629977 | Carrie Pekor | Social Worker | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2015-09-15 |
| 1912125444 | Claire R. Levine | Social Worker | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2007-04-22 |
| 1346363603 | Rachel Crystal | Psychologist | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2007-04-09 |
| 1245380377 | Lisa H. Wolfe | Psychologist | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2007-01-11 |
| 1487713285 | Susan G Falkoff | Social Worker | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2006-12-07 |
| 1871663989 | Jill A Fieleke | Nurse Practitioner | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2006-11-08 |
| 1013952753 | Janice Stubblefield-tave | Social Worker | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2006-06-17 |
| 1922047679 | Audrey Wagner | Psychologist | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548735327 | Gladys Nakungu Kasansula | Counselor | Square Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472 | 2018-10-09 |
| 1447741962 | Hannah Edward | Optometrist | 550 Arsenal Street, Watertown, MA 02472 | 2018-05-21 |
| 1982193504 | Ruth Audrey Silverstein | Social Worker | Perkins School for The Blind, 175 North Beacon Street, Watertown, MA 02472 | 2018-05-09 |
| 1376067355 | Mostafa Medhati | Acupuncturist | 265 Lexington St., Watertown, MA 02472 | 2017-08-01 |
| 1003346313 | Eric Trant | Specialist/Technologist | 50 Columbia Street, Watertown, MA 02472 | 2017-06-19 |
| 1477007730 | Neangkanika Chea | Nurse Practitioner | 2 Repton Place, Apt 2204, Watertown, MA 02472 | 2016-08-04 |
| 1396128120 | Michelle Soares Darocha | Dentist | 18 Hovey Street, Watertown, MA 02472 | 2015-06-29 |
| 1760875496 | Ece Evin Yildirim | Acupuncturist | 557 Mt. Auburn St, Watertown, MA 02472 | 2015-03-05 |
| 1396140927 | Fabrizia Torazzi | Behavioral Analyst | 51 Water Street, Suite 200, Watertown, MA 02472 | 2014-10-24 |
| 1265774392 | Emilia Ann Fulop | Social Worker | 127 North Beacon Street, Watertown, MA 02472 | 2013-03-27 |
| Find all providers in zip 02472 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285123893 | Jennifer Smith Phd LLC | Psychologist | 10 Oliver Rd Unit 3, Watertown, MA 02472-4136 | 2018-05-09 |
| 1669746228 | Meaghan Creedon | Psychologist | 40 Spring St Ste 215, Watertown, MA 02472-3474 | 2012-02-29 |
| 1699078295 | Sean Martin Markey | Psychologist | 124 Watertown St Ste 2d, Watertown, MA 02472 | 2010-12-21 |
| 1396052940 | Katherine Dellaporta | Psychologist | 124 Watertown St Ste 3d, Watertown, MA 02472 | 2010-09-02 |
| 1922331123 | Alexander Solodyna | Psychologist | 40 Spring Street, Suite 215, Watertown, MA 02472 | 2009-09-08 |
| 1477763316 | Soren R. Ekstrom | Psychologist | 29 Chester St, Watertown, MA 02472-4002 | 2007-05-22 |
| 1164574448 | Cheryl Morrier | Psychologist | 19472 Washington Street, Watertown, NY 13601-3694 | 2007-01-17 |
| 1952469389 | Jeanne Emery | Psychologist | 238 Arsenal St., Watertown, NY 13601 | 2006-12-05 |
| 1750455044 | William Michael Keane | Psychologist | 17 Spring St, Watertown, MA 02472-3411 | 2006-11-20 |
| 1619061108 | Michael D Figueroa | Psychologist | 9933 Aspen St., Watertown, NY 13601 | 2006-10-02 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.