Basic Information
| Provider Information | |||||||||
| NPI: | 1063935393 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUL | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | BROOKS | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 62 MARION AVE S | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029053806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084690748 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16 E WASHINGTON ST STE 2 | ||||||||
| Address2: | |||||||||
| City: | N ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027602384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084690748 | ||||||||
| FaxNumber: | 5085570234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2017 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 122625 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.