Provider Demographics
NPI:1386701571
Name:MARTIN, WILLIAM B
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:MARTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-3420
Mailing Address - Country:US
Mailing Address - Phone:978-249-6661
Mailing Address - Fax:
Practice Address - Street 1:215 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-9622
Practice Address - Country:US
Practice Address - Phone:413-774-1000
Practice Address - Fax:413-774-1197
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health