MEDICARE: RICHARD W HYNES JR. 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	LICSW120144	MA
2	1041C0700X	Clinical Social Worker	220099	MA

General Provider Information

NPI Number	:	1710234026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD W HYNES JR. LICSW

Provider Business Mailing Address
First Line	:	859 WILLARD ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-7482
Country	:	US
Telephone Number	:	617-847-1926
Fax Number	:	617-774-1490

Provider Business Practice Location Address
First Line	:	859 WILLARD ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-7482
Country	:	US
Telephone Number	:	617-847-1926
Fax Number	:	617-774-1490

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

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	02/10/2026

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