Individual
BRIAN RAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
169 ELM STREET, WALTHAM, MA 02453-5356
(781) 894-8440
(781) 894-1202
Mailing address
PO BOX 784, WATERTOWN, MA 02471-0784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2029046
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
703136
TUFTS
MA
01
—
99618201
NETWORK HEALTH
MA
01
—
M18633
BCBS
MA
01
—
NP01332
BOSTON MEDICAL
—
Enumeration date
10/23/2006
Last updated
07/08/2007
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