Individual
DR. CHARLES WOODROW STYRON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
173 MOUNT AUBURN ST, WATERTOWN, MA 02472-4005
(617) 489-5848
(617) 489-5848
Mailing address
35 WAVERLEY ST, BELMONT, MA 02478-1958
(617) 489-5848
(617) 489-5848
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6388
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0526916
—
MA
01
—
103012
CIGNA
MA
01
—
330623
HARVARD PILGRIM HEALTH CA
MA
01
—
6153012
UNITED BEHAVIORAL HEALTH
MA
01
—
95899
MANAGED HEALTH CARE
MA
01
—
W05271
BLUE CROSS
MA
Enumeration date
01/31/2006
Last updated
07/30/2010
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