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Contact Information

SQUARE PSYCHIATRY
124 WATERTOWN ST
WATERTOWN, MA02472-2576
 Phone: 617-926-8200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for SQUARE PSYCHIATRY · (Female)

NPI # 1609997667
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 1023920
  • MA License # 43500
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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