EDWIN W WILLIS NPI 1124561451

NPI Information

NPI: 1124561451
Provider Name: EDWIN W WILLIS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
774 ALBANY ST
BOSTON, MA
ZIP 02118
Phone: (617) 534-5613
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Edwin W Willis is an addiction (substance use disorder) counselor in Boston, MA. Edwin W Willis NPI is 1124561451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

774 ALBANY ST
BOSTON, MA
ZIP 02118-520
Phone: (617) 534-5613
Fax: (617) 534-6171

The enumeration date for this NPI number is 11/18/2016 and was last updated on 11/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1810 LADC1	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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