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General NPI Number Information
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NPI Number | 1649681826
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Entity Type | Individual
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Provider Name | JAMES GORDON PATTERSON LICSW
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Gender | Male
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Dates
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Enumeration Date | 05/09/2014
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 461 WASHINGTON ST APT 303
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City | BRIGHTON
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State | MA
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Zip | 02135-2650
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Country | US
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Telephone | 617-314-4048
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Fax |
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Provider Business Mailing Address
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Address Line | 705 MOUNT AUBURN ST TUFTS HEALTH PLAN - 3RD FLOOR
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City | WATERTOWN
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State | MA
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Zip | 02472-1508
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Country | US
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Telephone | 617-314-4048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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