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NPI Code Detail

MEDICARE: MR. JUSTIN STEPHEN SOMERS

MEDICARE: MR. JUSTIN STEPHEN SOMERS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1568753457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JUSTIN STEPHEN SOMERS
Provider Business Mailing Address
First Line : 334 N BROADWAY
Second Line : APT 203
City : SALEM
State : NH
Zip : 03079-2163
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 205 PORTLAND ST
Second Line :
City : BOSTON
State : MA
Zip : 02114-1721
Country : US
Telephone Number : 978-687-6300
Fax Number : 978-682-4843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2011
Last Update Date : 04/26/2011

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Directions to “ MR. JUSTIN STEPHEN SOMERS ” Practice Location

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