Provider Demographics
NPI:1518799741
Name:SCANNELL, WILLIAM EDWARD
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:SCANNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-2218
Mailing Address - Country:US
Mailing Address - Phone:617-898-7833
Mailing Address - Fax:
Practice Address - Street 1:400-402 N MAIN ST, RANDOLPH, MA 02368
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-986-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker