MEDICARE: PETER J EVERS LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1031376	MA

General Provider Information

NPI Number	:	1093729030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J EVERS LICSW

Provider Business Mailing Address
First Line	:	85 E NEWTON ST
Second Line	:	5TH FLOOR BEST
City	:	BOSTON
State	:	MA
Zip	:	02118-2340
Country	:	US
Telephone Number	:	617-414-8307
Fax Number	:	617-414-8306

Provider Business Practice Location Address
First Line	:	85 E NEWTON ST
Second Line	:	5TH FLOOR BEST
City	:	BOSTON
State	:	MA
Zip	:	02118-2340
Country	:	US
Telephone Number	:	617-414-8307
Fax Number	:	617-414-8306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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Directions to “ PETER J EVERS LICSW” Practice Location

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