MEDICARE: JOYCE WATSON-O'NEIL 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	104100000X	Social Worker	1018363	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1018363	OTHER	MA	LICSW LICENSE NUMBER

General Provider Information

NPI Number	:	1205310190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE WATSON-O'NEIL LICSW

Provider Business Mailing Address
First Line	:	5 STARBOARD AVE
Second Line	:
City	:	JAMESTOWN
State	:	RI
Zip	:	02835-3047
Country	:	US
Telephone Number	:	781-413-5346
Fax Number	:

Provider Business Practice Location Address
First Line	:	43 SCHOOL HOUSE RD
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02188-4142
Country	:	US
Telephone Number	:	781-335-8666
Fax Number	:

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

Provider Enumeration Date	:	09/18/2018
Last Update Date	:	09/18/2018

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