Healthcare Provider Details

I. General information

NPI: 1598692386
Provider Name (Legal Business Name): WILSON HENRY LLOYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MERRIMACK ST
LAWRENCE MA
01843-1779
US

IV. Provider business mailing address

26 ARTHUR AVE
MARBLEHEAD MA
01945-1108
US

V. Phone/Fax

Practice location:
  • Phone: 508-514-1378
  • Fax:
Mailing address:
  • Phone: 781-513-7502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: