Provider Demographics
NPI:1104088293
Name:MASTERSON, JOSCLYN (LICSW)
Entity type:Individual
Prefix:MRS
First Name:JOSCLYN
Middle Name:
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JOSCLYN
Other - Middle Name:
Other - Last Name:BERTOLINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:16 BOG VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7129
Mailing Address - Country:US
Mailing Address - Phone:617-519-4922
Mailing Address - Fax:
Practice Address - Street 1:363 COURT ST STE 1
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7306
Practice Address - Country:US
Practice Address - Phone:339-329-7772
Practice Address - Fax:508-746-8099
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217041104100000X
390200000X
MA1247201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program