John Augustus Northridge, LICSW
NPI #1174586168 in South Boston, Massachusetts
Provider Information
- NPI Number
- 1174586168
- Entity Type
- Individual
- Name
- John Augustus Northridge, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Apr 10, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 58 OLD COLONY AVE
- City
- South Boston
- State
- Massachusetts
- ZIP Code
- 02127-2406
- Phone
- (617) 268-1700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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